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First Heart Sound (Markedly Split)

First Heart Sound (Markedly Split)

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.


Auscultation Sounds

auscultation sound from lesson
waveform





Position

Patient position
The patient's position should be supine.

Listening Tips

S1:Splitting.
Features:Auscultate this sound over tricuspid and mitral areas


Waveform (Phonocardiogram)

Observe

//embedding heart animation

Authors

These authors contributed the audio recordings and text found in this reference guide: Jon Keroes, MD,Diane Wrigley, PA, and David Lieberman.
Medically reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.



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