Next, we shall listen at the upper left sternal edge using the diaphragm of the stethoscope. Again, the cotton swab when placed on the carotid will give us our timing device, so that we can together recognize systole. Everybody listen and watch respiration. [Cut-away]

And what did we hear at the upper left sternal edge? We heard normal inspiratory splitting of the second heart sound. When the patient breathed in [sounds], breathed out [sounds]. And, in addition, if w really tuned in to the two components of the second heart sound, we appreciated that the first component, or aortic component, was enhanced confirming the increased intensity of the second sound at the upper right sternal edge. So, our patient has normal inspiratory splitting with some increase in the aortic component of the second heart sound.