Another heart sound configuration which mimics a split second heart sound is a single second heart sound followed by a tumor plop (a transient which occurs early in diastole).
If you move the stethoscope head to the pulmonic area, the tumor plop will disappear. If you continue to hear two distinct sounds at the pulmonic area, the likelihood is that you are hearing a split second heart sound.
The timing and frequency of a tumor plop are identical to that of a third heart sound gallop. It is not possible to distinguish one from the other.
Second Heart Sound and a Tumor Plop Audio
Technique
The patient's position should be supine.
Auscultation Tips
Diastole:Tumor plop early in diastole, similar to a split S2Features:Tumor plop disappears over pulmonic valve area
Sound Wave
Observe Cardiac Animation
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
Second Heart Sound and a Tumor Plop | #50
