A 54-year-old male is admitted to the hospital with dyspnea. Imaging and physical examination and echocardiographic studies reveal severe mitral valve prolapse. Auscultation of this valve is best performed at which location?

The left fifth intercostal space, just below the left nipple, is typically the location to listen to the mitral valve. Although the mitral valve is located at the fourth intercostal space just to the left of the sternum, the sound is best realized "downstream" from the valve. The right lower part of the body of the sternum is the location of the tricuspid valve. The right second intercostal space near the lateral border of the sternum is the typical location of auscultation of the aortic valve. It is difficult to hear valvular sounds through bone, so auscultating directly over the middle of the manubrium is not a good choice. The left second intercostal space near the lateral border of the sternum is the site chosen typically for auscultation of the pulmonary valve.