Opening Snap brief, high-pitched, early diastolic sound (usually due to stenosis of an AV valve).
Mitral: more audible in expiration, lower LSB and apex, follows S2.
Tricuspid: more audible in its area, later in diastole than mitral.
Ejection Sound sharp, high-pitched, early systolic sound (in aortic/pulmonary stenosis), it's an opening snap.
Aortic: 2nd right ICS and apex.
Pulmonary: Upper left sternal border.
Clicks
(mid-systolic or
non-ejection)
In mitral regurgitation often denote prolapse.
Lower left sternal border and apex.
Pericardial Knock An earlier, high-pitched S3 (early diastolic). In constrictive pericarditis.
Pericardial Friction Rub Presystolic, systolic and early diastolic components.
The Patient upright, leaning forward and in expiration.
Tumor Plop Low-pitched, early or mid-diastolic, occurs in atrial mixoma.

Heart Sounds (cardiac cycle)