This adolescent presented with Obstructive Cardiomyopathy, Post Myotomy-Myectomy. Listen to the recorded heart sound, and record your observations in the box below. The stethescope is at the apex.

Note the characteristics of the sounds, and how they fit into the context of the cardiac cycle.

Describe first S1.Is it normal or abnormal? (ie: is it clearly audible as a single sound or is it obliterated by a murmur)? Is it preceded or followed by any additional sounds / is there a murmur / if so describe its timing (ie: systolic diastolic or continuous). If systolic further characterize it as ejection or regurgitant. If diastolic, further characterize it as proto or mid / late diastolic. Can you identify S2? If so, are both components audible, are they split normally or abnormally. Is there an S3 or an S4?

When you are satisfied with your answer, submit your response to see the actual initial diagnosis. Your name and an answer are required to get a response.

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Objectives | History | Physical Exam | Cardiac Cycle | Murmurs |
Criteria for Referral | Compare Sounds | Case Studies | Samples of Murmurs