Heart Sounds
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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S1 Lubb | Mitral and tricuspid valve closing
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S1 (Best heard) | Apex for Mitral and LLSB for tricuspid
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S2 Dubb | Aortic and pulmonary valves closing
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S2 (Best heard) | Right for aortic and left for pulmonic
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Split S1 | Mitral and tricuspid valves closing at different times.
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Split S1 (Best heard) | Apex and LLSB
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Split S1 | Normal sound, but could be abnormal and indicate RBBB
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Split S2 | Aortic and pulmonary valves closing at different times
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Split S2 (best heard) | Base Left
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Splint S2 | Normal: inspiration only
Wide Split: mostly inspiration May indicate RBBB or pulmonary HTN
Fixed Split: inspiration and expiration equally. SIGN of ATRIAL DEFECT
Paradoxical Split: Expiration only: AORTIC STENOSIS and LBBB.
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S3 "Kentucky" | Ventricles filling with blood
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S3 "Kentucky"(best heard) | Apex with bell and lying on left side
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S3 "Kentucky" | Heard immediately after S2 and does not vary with inspiration
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Physiologic S3 | Normal finding: in children and young adults with increased blood volume(prego,anemic and hyperthyroidism) Disappears when patient sit up
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Pathological S3 | Ventricular Gallop. Heard in HEART FAILURE MAINLY heard in elderly
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S4 "Tennessee" | Atrium contracting
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S4 "Tennessee" (best heard) | Apex with bell laying on left side
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S4 "Tennessee" | Immediately before S1
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Physiological S4 | Can be normal in people over 40 years especially after exercise.
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Pathological S4 | Atrial Gallop. Indicates poor compliance of ventricles and seen with CAD patients
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Created by:
kpnelson
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