A single first heart sound (S1) followed by an aortic ejection click (AEC) can also mimic a split first heart sound. An AEC follows S1 by 50 milliseconds.
An aortic ejection click is caused by thickened aortic valve leaflets. This is commonly seen in a bicuspid aortic valve, a congenital abnormality where someone is born with two aortic valve leaflets instead of the normal three.
Listen carefully to the second sound of the pair. If it is an AEC it will have a shorter duration and a higher pitch than the first sound of the pair (S1).
The AEC is best heard at the Aortic valve area where splitting of S1 is not heard.
First Heart Sound plus Aortic Ejection Click 109 Audio
First Heart Sound plus Aortic Ejection Click 109 Sounds
Half Speed First Heart Sound plus Aortic Ejection Click 109 Sounds
Technique
The patient's position should be sitting.
Auscultation Tips for First Heart Sound plus Aortic Ejection Click 109
Systole:high-pitched sound, early in systole, short durationSound Wave
First Heart Sound plus Aortic Ejection Click 109 Video
An aortic ejection click is caused by thickened aortic valve leaflets. This is commonly seen in a bicuspid aortic valve, a congenital abnormality where someone is born with two aortic valve leaflets instead of the normal three.
Authors and Sources
Authors and Reviewers
- ECG heart rhythm modules: Thomas O'Brien.
- ECG monitor simulation developer: Steve Collmann
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12 Lead Course: Dr. Michael Mazzini, MD.
- Spanish language ECG: Breena R. Taira, MD, MPH
- Medical review: Dr. Jonathan Keroes, MD
- Medical review: Dr. Pedro Azevedo, MD, Cardiology
- Last Update: 11/8/2021
Sources
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Electrocardiography for Healthcare Professionals, 6th Edition
Kathryn Booth and Thomas O'Brien
ISBN10: 1265013470, ISBN13: 9781265013479
McGraw Hill, 2023 -
Rapid Interpretation of EKG's, Sixth Edition
Dale Dublin
Cover Publishing Company -
EKG Reference Guide
EKG.Academy -
12 Lead EKG for Nurses: Simple Steps to Interpret Rhythms, Arrhythmias, Blocks, Hypertrophy, Infarcts, & Cardiac Drugs
Aaron Reed
Create Space Independent Publishing -
Heart Sounds and Murmurs: A Practical Guide with Audio CD-ROM 3rd Edition
Elsevier-Health Sciences Division
Barbara A. Erickson, PhD, RN, CCRN -
The Virtual Cardiac Patient: A Multimedia Guide to Heart Sounds, Murmurs, EKG
Jonathan Keroes, David Lieberman
Publisher: Lippincott Williams & Wilkin)
ISBN-10: 0781784425; ISBN-13: 978-0781784429 - Project Semilla, UCLA Emergency Medicine, EKG Training Breena R. Taira, MD, MPH
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ECG Reference Guide
PracticalClinicalSkills.com
First Heart Sound plus Aortic Ejection Click 109 | #43
