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


Position

The patient's position should be supine.
Listening Tips
S1:Splitting.Features:Auscultate this sound over tricuspid and mitral areas
Waveform (Phonocardiogram)
Observe
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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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