First Heart Sound (Markedly Split) | Auscultation #16 | Lesson with Audio
Where to Auscultate
 
            
The patient was supine during auscultation.
Description
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.Phonocardiogram
Anatomy
First Heart Sound (Markedly Split)
Authors and Sources
Authors and Reviewers
- 
                    Heart sounds by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient.
- Lung sounds by Diane Wrigley, PA
- Respiratory cases: William French
- 
                    David Lieberman, Audio Engineering
- 
                    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.
- 
                    Last Update: 11/10/2021 
Sources
- 
                    
                        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
- PESI Faculty - Diane S Wrigley
- 
                   
                        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




