The nurse is auscultating the apical pulse over the PMI (point of maximum impact). Which heart sounds would be audible?

  • S2 and S3
  • S3 and S4
  • S4 and S1
  • S1 and S2
Number 4 is correct.
Heart sounds S1 (tricuspid and mitral valves close) and S2 (aortic and pulmonic valves close) are auscultated to determine the apical pulse over the point of maximal impact. The third heart sound (S3) occurs slightly after S2. The fourth heart sound (S4) is heard slightly before S1.