Auscultation in Primary Care First and Second Heart Sounds - Reduced Intensity This is a simulation of a first heart sound and a second heart sound with greatly reduced intensity. This can be seen in an obese patient or a patient with emphysema. It is a challenge to your ability to hear these reduced intensity sounds. play pause Position: Mitral Chestpiece: Diaphragm Maneuver: Supine Phonocardiogram Cardiac Animation Table of Contents 1First and Second Heart Sounds - Normal and Unsplit 2First and Second Heart Sounds - Reduced Intensity 3Second Heart Sound - Splitting 4Third Heart Sound Gallop 5Fourth Heart Sound Gallop 6Third and Fourth Heart Sound Gallop 7Summation Gallop at 120 beats per minute 8Second Heart Sound - Fixed Splitting 9Mid-Systolic Click 10Mitral Valve Leaflet Prolapse 11Aortic Stenosis (Diamond Shaped Systolic Murmur) 12Aortic Regurgitation (Decrescendo Diastolic Murmur) 13Mitral Regurgitation (pansystolic Murmur) 14Mitral Stenosis (Diastolic Murmur) Practice Drill