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Timing of sounds and events in the cardiac cycle

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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  • first sound: closure of AV valves, indicates the beginning of ventricular systole
  • ejection sound:
    • systolic ejection click: this is an early systolic high pitched sound heard over the aortic area - may occur in cases of congenital sclerosis where the aortic valve remains mobile
    • non-ejection systolic click: high pitched sound heard during systle and best heard over the mitral area; may occur in mitral valve prolapse
  • second sound: closure of semilunar valves, marks the beginning of diastole, which is generally longer than systole
  • opening snap: opening of abnormal AV valves; occurs at a variable distance after the second sound
  • third sound: ventricular filling (beginning); mid - diastolic heart sound
  • fourth sound: ventricular filling with atrial contraction; late diastolic heart sound

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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