Loud First Heart Sound Lesson #660
The patient was supine during auscultation.
Description
The first heart sound is usually slightly louder than the second when auscultating at the mitral valve (apex).
The first heart sound is much louder than the second heart sound in this case. A thickened but still movable mitral valve is generating this particular sound. Look at the anatomy video to see the thickened mitral valve leaflets.
Loud first heart sounds can also be observed in patients with thin chests.
Phonocardiogram
Anatomy
Loud First Heart Sound
Notice the thickened mitral valve leaflets.
The first heart sound is much louder than the second heart sound. This can be produced by a thickened, but still mobile, mitral valve.
Authors and Sources
Authors and Reviewers
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Heart sounds by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient.
- Lung sounds by Diane Wrigley, PA
- Respiratory cases: William French
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David Lieberman, Audio Engineering
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Heart sounds mentorship by W. Proctor Harvey, MD
- Special thanks for the medical mentorship of Dr. Raymond Murphy
- Reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.
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Last Update: 11/10/2021
Sources
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Heart and Lung Sounds Reference Library
Diane S. Wrigley
Publisher: PESI -
Impact Patient Care: Key Physical Assessment Strategies and the Underlying Pathophysiology
Diane S Wrigley & Rosale Lobo - Practical Clinical Skills: Lung Sounds
- Essential Lung Sounds
Diane S. Wrigley, PA-C
Published by MedEdu LLC - PESI Faculty - Diane S Wrigley
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Case Profiles in Respiratory Care 3rd Ed, 2019
William A.French
Published by Delmar Cengage - Essential Lung Sounds
by William A. French
Published by Cengage Learning, 2011 - Understanding Lung Sounds
Steven Lehrer, MD
- Clinical Heart Disease
W Proctor Harvey, MD
Clinical Heart Disease
Laennec Publishing; 1st edition (January 1, 2009) -
Heart and Lung Sounds Reference Guide
PracticalClinicalSkills.com
