Each sound is first reproduced (the audio quality is excellent) and then is followed by a discussion of how the physical finding in question is best detected. The applicable physiology or pathophysiology and the clinical setting in which the sound may be heard are explained, all the while repeating the sound at intervals to facilitate learning. The narrative is easily followed and has a logical order in presenting the material. Dr. Mangione also covers areas that can be confusing to the budding clinician, such as the reasoning behind the use of the term crackles instead of rales to describe those adventitious sounds, and provides full coverage of other sounds, including the less familiar squawk or squeak. The common abnormal cardiac sounds are covered, including murmurs from aortic and mitral regurgitation and stenosis, S3 and S4 gallops, midsystolic clicks, and pericardial friction rubs.