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5 Cards in this Set
- Front
- Back
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Normal order of valve closing |
1. Mitral 2. Tricuspid 3. Aortic 4. Pulmonary |
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S1 splitting |
Usually not clinically detectable If it is, due to RBBB |
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S2 splitting |
1. Increased normal splitting - any delay in RV emptying. Causes - RBBB, PS, VSD, MR 2. Fixed splitting S2 - ASD leads to equalisation of atrial volume loads. 3. Reverse splitting - (P2 occurs first; splitting in expiration. Causes - LBBB, severe AS/coarctation of aorta. |
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S3 |
- low-pitched, diastolic rumble. - Patho S3 - reduced vent. compliance. Inc atrial and vent. EDV - LV S3 - louder at apex/expiration. Can be normal (preg, thyrotox). Important sign of LV failure and dilation. Also AR, MR, VSD, PDA - RV S3 - louder at left sternal edge/inspiration. RV failure or constrictive pericarditis.
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S4 |
- low-pitch, late diastolic sound. - high-pressure atrial contraction causes wave reflected of poorly compliant ventricle. - LV S4 - reduced compliance due to AS, acute MR, systemic HTN, IHD. ?angina, MI. - RV S4 - reduced compliance due to pulm HTN or PS. |
