First Heart Sounds

First Heart Sound with Aortic Ejection Click Lesson #664

patient thorax when auscultating by stethoscope

The patient was sitting during auscultation.

Description

An aortic ejection click is produced by thickened aortic valve leaflets. These clicks can be generated in a bicuspid aortic valve, which is a congenital abnormality with two aortic valve leaflets instead of the three normal leaflets.

A single first heart sound (S1) followed by an aortic ejection click (AEC) can mimic a split first heart sound. An AEC follows S1 by 50 milliseconds. An AEC will have a higher pitch and shorter duration than S1. The recommended auscultation point is the aortic valve area where splitting of S1 is not heard.

Phonocardiogram

Anatomy

First Heart Sound with Aortic Ejection Click

An aortic ejection click is caused by thickened aortic valve leaflets. This is commonly seen in a bicuspid aortic valve, a congenital abnormality where someone is born with two aortic valve leaflets instead of the normal three.

Authors and Sources

Authors and Reviewers

Heart sounds by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient.
Lung sounds by Diane Wrigley, PA
Respiratory cases: William French
David Lieberman, Audio Engineering
Heart sounds mentorship by W. Proctor Harvey, MD
Special thanks for the medical mentorship of Dr. Raymond Murphy
Reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.
Last Update: 11/10/2021

Sources

Heart and Lung Sounds Reference Library Diane S. Wrigley
Publisher: PESI
Impact Patient Care: Key Physical Assessment Strategies and the Underlying Pathophysiology
Diane S Wrigley & Rosale Lobo
Practical Clinical Skills: Lung Sounds
Essential Lung Sounds Diane S. Wrigley, PA-C
Published by MedEdu LLC
PESI Faculty - Diane S Wrigley
Case Profiles in Respiratory Care 3rd Ed, 2019
William A.French
Published by Delmar Cengage
Essential Lung Sounds by William A. French
Published by Cengage Learning, 2011
Understanding Lung Sounds Steven Lehrer, MD
Clinical Heart Disease W Proctor Harvey, MD
Clinical Heart Disease
Laennec Publishing; 1st edition (January 1, 2009)
Heart and Lung Sounds Reference Guide
PracticalClinicalSkills.com