How to listen to heart sounds
Other platforms explain it with text and video. In VMS you practice it on the patient.
Good auscultation is about method: a quiet room, the right side of the stethoscope and a fixed order. Then every sound has a name.
Step by step
Set up
Quiet room, warm stethoscope, skin contact (never through clothing), patient lying at 30 to 45 degrees. [1]
Know your stethoscope
Diaphragm pressed firmly for high sounds (S1, S2, most murmurs); bell resting lightly for low sounds (S3, S4, mitral stenosis). [2]
Listen at the four areas
Aortic, pulmonic, tricuspid and mitral, first with the diaphragm and then with the bell. [1]
Find S1 and S2
S1 is heard as the carotid pulse rises; S2 follows. The gap between S1 and S2 is systole, the longer gap after S2 is diastole. [2]
Listen for extra sounds
S3 just after S2 (normal in young people, a sign of heart failure in older adults); S4 just before S1 (a stiff ventricle). [2]
Describe any murmur
Timing (systolic or diastolic), where it is loudest, where it spreads, grade 1 to 6, pitch and quality. [1]
Use positions
Left side for mitral sounds with the bell; sitting forward after breathing out for aortic sounds. [2]
Record
For example: "S1 and S2 normal, no murmurs, no extra sounds" or the full murmur description. [1]
Common errors
- Using the bell with heavy pressure (it becomes a diaphragm).
- Not timing with the pulse.
- Listening only at one area.
Practice it in VMS
In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
VMS cases that train this skill
Sources
- Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)
- Stanford Medicine 25 (bedside exam)
Steps adapted from Open RN, Nursing Skills 2e (Chippewa Valley Technical College), licensed under CC BY 4.0. Facts and steps also follow Stanford Medicine 25 (bedside exam). VMS is not affiliated with these organizations. Updated: 2026-10-11.