Ejection Click

An ejection click is an early systolic sound, and occurs when an abnormal aortic or pulmonic valve (eg, bicuspid aortic valve) opens, or from ejection of blood into a dilated great vessel (aorta or pulmonary artery, such as in pulmonary hypertension). The sound is close to S1 and can sound like an S1 split. However, an ejection click is best appreciated over the aortic and pulmonic valves (base of the heart), as opposed to the split S1 which is best heard over the apex of the heart.
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Patient 3

This is a young man with sickle cell anemia with associated pulmonary hypertension.

Ejection Click

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