If the splitting of the first heart sound is large (about 50 milliseconds) it is an indication of an abnormal condition called Right Bundle Branch Block. The splitting is most clearly heard at the tricuspid area.

In the mitral valve area, the mitral component is louder.

At 50 milliseconds, the splitting of the first heart sound is clearly audible.

After reviewing the sound, use the waveform and anatomy tabs for more information about this sound.


First Heart Sound (Markedly Split)
maneuver
Position: Tricuspid
Maneuver: Supine
Chestpiece: Diaphragm