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First Heart Sound (Minimally Split)

Virtual Auscultation

patient torso with stethoscope chestpiece
patient position during auscultation

The patient's position should be supine.

Lesson

On occasion the first heart sound can be made up of two separate sounds separated by a very small interval (20-30 milliseconds). The Mitral component (caused by closure of the Mitral valve) comes first and is louder than the Tricuspid component (caused by closure of the Tricuspid valve). A minimally split first heart sound is a normal variation of the first heart sound.

Waveform





Heart Sounds Video



Authors and Reviewers

Authored by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient. Medically reviewed by Dr. Barbara Erickson, PhD, RN, CCRN. Last Update: 11/28/2021


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