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Second Heart Sound and a Tumor Plop

Second Heart Sound and a Tumor Plop

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.


Auscultation Sounds

auscultation sound from lesson
waveform





Position

Patient position
The patient's position should be supine.

Listening Tips

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


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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