S1 (split)
The differential contraction of the left and right ventricle causes a splitting of the first heart sound.
An abnormally large splitting of the first heart sound is heard when there are:
- either conduction abnormalities:
- right bundle branch block
- pacing from an electrode on the LV
- left ventricular ectopics
- or mechanical causes:
- Ebsteins anomaly
- atrial septal defect
- tricuspid stenosis
Reference
- Voin V, Oskouian RJ, Loukas M, Tubbs RS. Auscultation of the heart: The Basics with Anatomical Correlation. Clin Anat. 2017 Jan;30(1):58-60.
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