Symptom >> Internal Medicine >> Cardiology

Apical first heart sound hypersensitivity

Introduction
Cause
Examine
Diagnosis

Introduction

Introduction The first heart sound of the apex is the heart sound enhancement.

Cause

Cause

The first heart sound enhancement: There are four factors that affect the strength of the first heart sound. 1, the anatomical lesion nature of the atrioventricular valve; 2, the rate of rise of ventricular pressure in the systolic phase; 3, the filling of the ventricular diastolic; 4, the location of the atrioventricular valve when the ventricle contracts.

The first heart sound hyperthyroidism is common in mitral stenosis, because the blood flow through the stenotic mitral valve into the left atrium is obstructed, the left ventricular filling is less in the diastolic period, and the mitral valve is still in the maximum open state before the ventricular contraction. The free edge of the cuspidate leaves away from the valve orifice, and the free edge of the ventricular contraction moves to a greater extent, resulting in greater vibration, so the first heart sound of the apex is hyperthyroidism. The sound of the second heart sound of the mitral stenosis is hyperthyroidism and open, and the sound is the first heart sound of complete atrioventricular block.

Examine

an examination

Related inspection

Cardiovascular angiography Doppler echocardiography Cardiovascular disease ultrasound diagnosis dynamic electrocardiogram (Holter monitoring) ECG

The auscultation tone is lower and blunt, the intensity is louder, lasts longer (lasting about 0.1s), and appears at the same time as the apex beat, the loudest at the apex.

Diagnosis

Differential diagnosis

Distinguish between the second heart sound and the third heart sound.

The second heart sound auscultation features: the tone is higher and brittle, the intensity is weaker than S1, and the duration is shorter (about 0.08s), not synchronized with the apex beat, the loudest at the bottom of the heart.

The characteristics of the second heart sound auscultation: the tone is light and low, and the duration is short (about 0.04 s). It is limited to the apex or the upper part of the apex, and the supine position and exhalation are clearer.