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Diastolic sounds - early

Mitral (and tricuspid) opening snap:

• Intensity reflects valve mobility.
• Interval between A2 and OS is inversely related to stenosis severity.

Mitral prosthetic opening sound.

Tumor plop

• Occurs when right and/or left atrial myxoma prolapse across AV valve is abruptly tethered early in diastole.

Pericardial knocks

• Occur early in diastole.

Noncompliant left ventricular sound

• Can occur in patients with massive mitral regurgitation