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First Heart Sound (Markedly Split)

Heart Sounds Lesson

maneuver image
Supine
torso and chestpiece
Diaphragm

If the splitting of the first heart sound is large (about 50 milliseconds) it is an indication of an abnormal condition called Right Bundle Branch Block. The splitting is most clearly heard at the tricuspid area.

In the mitral valve area, the mitral component is louder.

At 50 milliseconds, the splitting of the first heart sound is clearly audible.

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