Late Systolic Click and S2 Lesson #672

patient thorax when auscultating by stethoscope

patient position during auscultation
The patient was supine during auscultation.

Description

Note that certain heart sound patterns can resemble S2 splitting. A late systolic click plus a single-second heart sound (S2) in one such condition. In this case, a late systolic click occurs immediately before the second heart sound. This incorrect leads to a finding of a split S2.

To correctly evaluate the sounds, carefully to the two sounds. If the first of the pair is of higher frequency and shorter duration than the second, it is a late systolic click followed by a single second heart sound.

Moving the stethoscope chestpiece to the pulmonic area is also a good technique for distinguishing a late systolic click from a split S2. The single S2 will be present and the late systolic click will diminish or disappear

Degeneration of the mitral valve leaflets causes these leaflets to make a "clicking" sound during late systole. In the video, you will see prolapse of the anterior lateral mitral valve leaflet which generates the late systolic click.

Phonocardiogram

Anatomy

Late Systolic Click and S2


Authors and Sources

Authors and Reviewers

Sources


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