Patient: During the physical examination, the doctor said that three sounds could be heard from the pericardial region, the ECG was normal, and the heart rate was 80 beats. What you are referring to is the third heart sound, right? The normal heart sounds in people are the first and second heart sounds, and the third heart sound is usually not heard. However, some children and young people can hear the third heart sound, especially if they are thin. Hearing a third heart sound is not necessarily abnormal, but can also be normal. There is also a splitting of the first or second heart sound, which also creates three heart sounds, which is a little more complicated. If the second heart sound is a fixed split, you should check the echocardiogram to see if there is a congenital heart defect in the atrial diaphragm. It is recommended that you have an echocardiogram and a chest radiograph.