Cardiology Heart Sounds

Loud S1

| | | | --- | --- | | Causes of Loud S1 | | | Condition | Mechanism | | Short P-R interval (0.08-0.12 second) | Valve wide open from recent atrial contraction | | Premature beats, tachycardia | Valves wide open from rapid early diastolic filling | | Mitral stenosis, tricuspid stenosis, atrial myxoma | Texture of valve; valve maximally open from prolonged ventricular filling | | Exercise, fever, anemia, thyrotoxicosis, epinephrine, anxiety, pregnancy, A-V fistula | Forcible ventricular contraction (plus tachycardia) | | Thin chest wall, child | Minimal damping effects |

Card Tutorial

Patient 2

This patient was admitted to the hospital after suffering multiple embolic events (to brain and kidney) and an episode of severe hemoptysis, and was later determined to have severe mitral stenosis. One of the classic features of mitral stenosis is a loud S1, demonstrated in these videos. You may also note the opening snap and rumbling diastolic murmur with pre-systolic accentuation.

Loud S1

Annotated

Loud S1

Annotated