First Heart Sound - Loud | Auscultation Cheat Sheet with Sounds & Video | #38

Usually, 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.

Auscultation Audio

Technique

The patient's position should be supine.

Auscultation Tips

S1:Increased intensity
S2:Softer intensity than S1

Sound Wave

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.

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

Sources

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
ECG Reference Guide
PracticalClinicalSkills.com

Return to Reference Guide Index Page

First Heart Sound - Loud | Auscultation Cheat Sheet with Sounds & Video | #38