Opening Snap and Second Heart Sound

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An opening snap occurring early in diastole along with a single second heart sound can mimic a split second heart sound.

An opening snap is caused by thickened valve leaflets. When they open it produces a snapping sound.

The more severe the thickening the earlier in diastole the opening snap occurs. In this example you are hearing an opening snap which occurs 75 milliseconds after the start of the second heart sound.
Opening Snap and Second Heart Sound
The recommended auscultation position for the stethoscope is the Mitral position. For this sound, use stethoscope's Diaphragm.


maneuver
The recommended patient position is Supine

Phonocardiogram

waveform
This waveform plots sound amplitude on the vertical axis against time on the horizontal axis.

Heart Animation

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Listening Tips
A synopsis of important sound features and timing for this abnormality.
Diastole: Snap early in diastole, higher pitch than S2.
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