Heart and Neck Vessels CH 91 N400 Physical Assessment Abnormal Findings FSMFN

the opening snap is a very early diastolic sound usually produce by the opening of the stenotic mitral valve. It is heard best just medial to the apex and along the lower left sternal border, but may be heard throughout the precordium and will not vary with respirations. It has a high pitch and snapping quality which to help to distinguish it from and S3. It is heard best with the diaphragm of the stethoscope.

When S3 and S4 occur simultaneously. This is associated with severe CHF

Heard just after the first heart sound, it is a high frequency sound that can be heard throughout the precordium. It is produced by the opening of a diseased aortic or pulmonic valve or by rapid ejection through normal valves

Is a high frequency, snapping sound that can be heard in middle of late systole. This sound can be heard over the mitral or apical area. A mid-systolic click is attributed to mitral valve leaflet prolapse during left ventricular ejection.

Are not confined to one pertion of the cardiac cycle. The pericardial frictin rub may ahve three short componenets; atrial systole, ventricular systole, and vetricular diastole. Usually the first two componenets are present. The location is variable but usually is heard best at the third intercostal space to the left of the sternum. Intensity is also variable but may increase when the patient leans forward and exhales. Quality is scratcy or scraping with a high pitch (heard best with the diaphragm)