When auscultating the tricuspid area, you hear a split S1 . You determine that the split is wider than usual during inspiration and is still heard during expiration. An abnormally split S1 is commonly heard in mitral stenosis because the
a. tricuspid valve closes before the mitral valve.
b. mitral valve closes before the tricuspid valve.
c. mitral valve causes a longer and louder sound as it closes.
d. mitral valve causes a loud sound as it opens.
A
A split S1 with an abnormally wide split is pathological. The split is wider than usual during inspiration and is still heard on expiration. In mitral stenosis, the tricuspid valve can close before the mitral valve closes because of calcification of the diseased mitral valve. If the mitral valve closes before the tricuspid valve, it is caused by greater pressure in the left side of the heart. An abnormally split S1 is not related to the sound of the mitral valve as it closes or opens.
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