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First Heart Sound (Markedly Split)

Virtual Auscultation

patient torso with stethoscope chestpiece
patient position during auscultation

The patient's position should be supine.

Lesson

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.

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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