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Second Heart Sounds
Second Heart Sound and Late Systolic Click
Sounds
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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 tab you will see prolapse of the anterior lateral mitral valve leaflet which is the cause of the late systolic click.
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The recommended auscultation position for the stethoscope is the
Mitral
position. For this sound, use stethoscope's
Diaphragm
.
The recommended patient position is
Supine
Phonocardiogram
This waveform plots sound amplitude on the vertical axis against time on the horizontal axis.
Heart Animation
Lessons
1
Second Heart Sound - Physiologically Split #2
2
Second Heart Sound with Persistent Splitting
3
Second Heart Sound with Fixed Splitting
4
Second Heart Sound: Fixed Splitting, Increased Aortic Intensity
5
Second Heart Sound: Fixed Splitting, Decreased Aortic Intensity
6
Second Heart Sound and Late Systolic Click
7
Second Heart Sound and a Tumor Plop
8
Opening Snap and Second Heart Sound
Practice Drill
Listening Tips
A synopsis of important sound features and timing for this abnormality.
Systole:
Higher pitched click late in systole with short duration.
CaseID
49
CourseID
24
CourseCaseOrder
6
ID
37