Heart Sounds

Question 1

S3

Seen in?

Answer 1

• passive filling of ventricles
• N in 🤰🏻
• Systolic HF, MR, DCM
• heard @ apex

Question 2

S4 seen in?

Answer 2

• Atrial gallop before S1
• atrial contraction d/t blood striking a stiff LV
• N in elderly + children
• diastolic dys(f): LVH, HCM

Question 3

splitting

Physiologic:

Narrow:

Wide:

Paradoxical:

Answer 3

Physiologic: A2 — P2 during inspiration

Narrow: delayed A2 - AS, HTN, LBBB, HCM

Wide: delayed P2 - PS, PHTN, ASD, RBBB, VSD

Paradoxical: P2 closes before A2