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Heart sounds (ejection, aortic)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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This is heard in early systole after the first heart sound. The sound is often best heard at the apex.

The sound is generated by the abrupt halt of the fused aortic cusps in systole when they fail to fold onto the wall of the aorta.

Possible causes include:

  • an aortic valve that does not open fully - a bicuspid aortic valve
  • aortic stenosis where there is a mobile valve. An aortic ejection sound signifies that the stenosis is at valve level. Calcification causes the ejection sound to disappear. The sound is also absent in supravalvular and subvalvular stenosis

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