You are incorrect - our patient's acoustic events at the upper right sternal edge are best described as an ejection sound, a systolic ejection murmur, a single accentuated S2 and an early diastolic murmur.


Your choice: S4 + systolic ejection murmur + single S2 + single S3

This is a graphic example of an S4, systolic ejection murmur, single S2 and S3. Note absence of both an ejection sound and a diastolic murmur.