A medical device system and method that includes receiving an A2 heart sound signal from a first external acoustic sensor, receiving a P2 heart sound signal from a second external acoustic sensor, determining at least one A2 heart sound signal parameter from the A2 heart sound signal, determining at least one P2 heart sound signal parameter from the P2 heart sound signal, and based on the at least one P2 heart sound signal parameter, estimating pulmonary arterial pressure.