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Systolic sounds - early systole
Aortic ejection sound
- Occurs when bicuspid aortic valve reaches fully open position.
- Also occurs in aortic root dilation
- Similar in pitch to A2 and P2.
- Position change (e.g. standing) does not affect timing.
Pulmonic ejection sound
- Decreases with inspiration.
- Occur when stenotic pulmonic valve reaches fully open position.
- Also occurs in pulmonary artery dilation.
- Similar in pitch to A2 and P2.
- Position change does not affect timing.
Mechanical aortic valve prostheses
- Ball valves, especially, generate early systolic sounds.
- Bioprosthetic valves do not.
