Second Heart Sounds

Second Heart Sound and a Tumor Plop Sounds

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.

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The recommended auscultation position for the stethoscope is the Mitral position. For this sound, use stethoscope's Diaphragm.

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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.
Diastole: Tumor plop early in diastole, similar to a split S2.
Tumor plop disappears over pulmonic valve area.

CaseID	50
CourseID	24
CourseCaseOrder	7
ID	38