Second Heart Sound and Late Systolic Click
Second Heart Sound and Late Systolic Click
Certain heart sound configurations mimic a split second heart sound. One of these conditions is a late systolic click plus a single second heart sound (S2). Since the late systolic click occurs just before the S2, it is easy to confuse the two with a split S2. Listen 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. Another way of distinguishing a late systolic click from a split S2 is to move the stethoscope head to the pulmonic area. The late systolic click will disappear, and you will only hear the single S2. A late systolic click is caused by degeneration of the mitral valve leaflets. This degeneration causes the closing of the leaflets to make a "clicking" sound during late systole. On the anatomy video you will see prolapse of the anterior lateral mitral valve leaflet which is the cause of the late systolic click.Auscultation Sound From Lesson


Patient Recording


Patient Recording - Half Speed Playback


Position

The patient's position should be supine.
Listening Tips
Systole:higher-pitched click late in systole with short durationWaveform (Phonocardiogram)
Observe Cardiac Animation
Second Heart Sound and Late Systolic Click | #49
Authors and Reviewers
Authored by Dr. Jonathan Keroes, MD and Diane Wrigley, PA.Medically reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.
Last Update: 12/06/2021
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Jonathan Keroes, David Lieberman
Publisher: Lippincott Williams & Wilkin)
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Ventricular Function Curves in the Exercising Dog
JONATHAN KEROES , ROGER R. ECKER , and ELLIOT RAPAPORT
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American Journal of Obstetrics Gynecology, VOLUME 154, ISSUE 4, P921-923, APRIL 01, 1986
Susan K Hendricks, MD, Jonathan Keroes, MD, Michael Katz, MD -
A Multimedia Guide to Heart Sounds and Murmurs
January 2007 JAMA The Journal of the American Medical Association 297(2):217-218
DOI:10.1001/jama.297.2.217. M. Saleem Seyal, MD, Reviewer
Sources
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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
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Diane S. Wrigley, PA-C
Published by MedEdu LLC - PESI Faculty - Diane S Wrigley
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Case Profiles in Respiratory Care 3rd Ed, 2019
William A.French
Published by Delmar Cengage - Essential Lung Sounds
by William A. French
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Stevben Lehrer, MD
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