The third heart sound for diagnosis of acute heart failure
Michael Johnston1, Sean P Collins, Alan B Storrow
1Vanderbilt University Medical Center, 703 Oxford House, 1313 21st Avenue, South, Nashville, TN 37232-4700, USA. michael.johnston.1@vanderbilt.edu
Abstract:
Dyspnea is a common presenting complaint in the emergency department (ED). Rapid identification of heart failure as the etiology leads to early implementation of targeted therapies. Although having only intermediate sensitivity, the S3 is a highly specific finding among older adults with heart failure. Identification of an S3 by routine auscultation can be problematic given the chaotic and noisy ED environment, patient comorbid conditions, and intolerance of ideal positioning for auscultation. Technologies using computerized analysis of digitally recorded heart tones have recently been developed to aid the clinician with bedside detection of abnormal heart sounds. Data using these technologies and their applications in the ED are reviewed as well as implications for future use and research.
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S1 (First Heart Sound)-
S1 is made by the closure of the mitral and tricuspid valves (atrioventricular valves), marking the beginning of systole.
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S2 is made by the closure of the aortic and pulmonic valves (semilunar valves), marking the end of the systole.
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