First Heart Sound - LoudUsually, the first heart sound is slightly louder than the second heart sound when heard in the Mitral valve area. In this case the first heart sound is much louder than the second heart sound. This can be produced by a thickened, but still mobile, mitral valve. Look at the anatomy video to see the thickened mitral valve leaflets. A very loud first heart sound can be an indication of mitral stenosis.
The patient's position should be supine.
Auscultation TipsS1:Increased intensity
S2:Softer intensity than S1
Observe Cardiac Animation
Notice the thickened mitral valve leaflets. The first heart sound is much louder than the second heart sound. This can be produced by a thickened, but still mobile, mitral valve.
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Authors and Sources
Authors and Reviewers
- ECG heart rhythm modules: Thomas O'Brien.
- ECG monitor simulation developer: Steve Collmann
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
Electrocardiography for Healthcare Professionals, 5th Edition
Kathryn Booth and Thomas O'Brien
ISBN10: 1260064778, ISBN13: 9781260064773
McGraw Hill, 2019
Rapid Interpretation of EKG's, Sixth Edition
Cover Publishing Company
12 Lead EKG for Nurses: Simple Steps to Interpret Rhythms, Arrhythmias, Blocks, Hypertrophy, Infarcts, & Cardiac Drugs
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
First Heart Sound - Loud | Auscultation Cheat Sheet with Sounds & Video | #38