You are incorrect - our patient's acoustic events at the lower left sternal edge demonstrate a third heart sound (S3) and a fourth heart sound (S4) heard during inspiration. Normal first and second sounds are also heard.
Your choice: S3 + S4 in inspiration and expiration
This is a graphic example of a fourth heart sound, a first heart sound, a second heart sound and a third heart sound. Note that the third and fourth sounds are low frequency.