Abnormalities, such as a previous heart attack, decreased thyroid function, congestive heart failure, coronary artery disease, AV Blocks, cardiomyopathy, and mitral regurgitation. The anatomy video provides one example of such conditions.
In addition, thick chest walls can dampen the transmission of heart sounds, resulting in the observation of diminished heart sounds
Listen

The patient's position is supine.
Visualize
Observe
A decrease in the vigor of contraction of the left ventricle causes decreased intensity first heart sound.