Above, you can see the auscultatory areas of the heart. There are four traditional valve areas noted– these are not the actual anatomical locations of the valves, but where they are heard the best. The sound is projected in the direction of blood flow. Understanding the valve areas allows for more accurate assessment of heart murmurs.

The valve areas are:

  • Aortic valve area– 2nd right intercostal space
  • Pulmonic valve area– 2nd left intercostal space
  • Tricuspid valve area– left lower sternal border
  • Mitral valve area– 5th intercostal space at approximately the left midclavicular line

Sounds produced by the valves may also be heard over the precordium (area directly over the great the heart and great vessels). It is recommended to inch your stethoscope in a rough ‘Z’ pattern from the base of the heart, across and down, then over to the apex.

Jarvis, C. (2012). Physical Examination and Health Assessment, 6th Edition. [Pageburstl]. Retrieved from https://pageburstls.elsevier.com/#/books/978-1-4377-0151-7/