Accentuated S1: Causes & Reasons

Warning: Do not use in emergencies, if pregnant, if under 18, or as a substitute for a doctor’s advice or diagnosis. Learn more

Possible Causes for Accentuated S1

Mitral Valve Stenosis

S1 Accentuation or Delay S1 is normally caused by closure of the mitral valve and is often accentuated or delayed in the context of mitral stenosis. [pathwaymedicine.org]

Auscultation of heart sounds will reveal a loud, accentuated S1 early in mitral stenosis and soft S1 in severe mitral stenosis (see Heart Sounds Topic Review ). [healio.com]

However, S1 accentuation and delay tend to become mild or disappear all together in late stages of the disease. [pathwaymedicine.org]

Atrial Myxoma

Note loud S1 and S2. Additional late systolic sound is also present. This patient had severe pulmonary hypertension; that is why S2 was accentuated. [cardiacauscultation.com]

Right Atrial Myxomas Right atrial myxomas are associated with a loud, early systolic, widely split S1 due to expression of the tumour from the right ventricle. [atlasgeneticsoncology.org]

A pulmonary ejection murmur with a delayed and accentuated pulmonic second sound may be heard. There may also be an early, late or prolonged diastolic murmur heard. [atlasgeneticsoncology.org]

Chronic Bronchitis

Carbohydrate antigen 19-9 (CA19-9) is the most frequently applied serum tumor marker for diagnosis of cancers in the digestive organs. However, some patients with benign diseases can have elevated serum levels of CA19-9 as well. The current study presents a 55-year-old female who was admitted to our hospital for[…] [ncbi.nlm.nih.gov]

Sinus Tachycardia

Sinus tachycardia ECG readout of an individual with sinus tachycardia. Here the heart rate is around 150. Specialty Cardiology Sinus tachycardia (also colloquially known as sinus tach or sinus tachy) is an elevated sinus rhythm characterized by an increase in the rate of electrical impulses arising from the sinoatrial[…] [en.wikipedia.org]

Thyrotoxic Heart Disease

A 29-year-old woman at 34 weeks' gestation with uncontrolled hyperthyroidism and thyrotoxic heart disease was admitted to urgency Cesarean section. After preoperative sedation and good communication, low-dose spinal anesthesia (7.5 mg 0.5 % bupivacaine) combined with epidural anesthesia (6 ml 2 % lidocaine) was[…] [ncbi.nlm.nih.gov]

Lown-Ganong-Levine Syndrome

Electrophysiologic study of a 55-year-old patient with Lown-Ganong-Levine syndrome associated with apical hypertrophic cardiomyopathy is reported. The patient had a history of recurrent attacks of tachyarrhythmia and his electrocardiogram showed a short P-R interval (0.10 sec) with narrow QRS complex and left[…] [ncbi.nlm.nih.gov]

Wolff-Parkinson-White Syndrome

Cardiac Affected children present with chest pain or chest tightness accompanied with dyspnoea, paroxysmal nocturnal dyspnoea and palpitations. These symptoms may be accompanied by light headedness and dizziness, and sometimes the child may faint during an acute attack. Other signs and symptoms may include[…] [symptoma.com]

Tricuspid Stenosis

A 47-year-old man with history of familial cardiomyopathy and orthotopic heart transplant at the age of 34 years presented severe tricuspid stenosis (TS) with a mean transvalvular gradient of 10 mm Hg. The patient opted against tricuspid valve replacement and was offered percutaneous transcatheter tricuspid[…] [ncbi.nlm.nih.gov]

Congenital Mitral Stenosis

S1 Accentuation or Delay S1 is normally caused by closure of the mitral valve and is often accentuated or delayed in the context of mitral stenosis. [pathwaymedicine.org]

Auscultation of heart sounds will reveal a loud, accentuated S1 early in mitral stenosis and soft S1 in severe mitral stenosis (see Heart Sounds Topic Review ). [healio.com]

Cardiac auscultation: Heart sounds • The S1 is accentuated because of a wide closing excursion of the mitral leaflets. • The degree of loudness of the S1 depends on the pliability [slideshare.net]

Hyperkinetic Heart Syndrome

Parasternal heave with normal S1 and accentuated P2. [lecturio.com]

Accentuated S1 while S2 is narrowly or paradoxically split. [lecturio.com]

Tricuspid Atresia

accentuated -often Single S2 -Holosyst murmur if Q thru VSD or ejection murmur if RVOT -w incr Qp, can hear S3 or middiast rumble at apex -hepatomegaly, esp if restricted [sites.google.com]

The first heart sound (S1)is single and may be accentuated. The 2nd heart sound (S2) is usually single. [msdmanuals.com]

[…] surgery) -dTGA --> Sx of pulm overcirc; hard to DDx (by exam) fr Type I if large VSD -Nl size newborn -LV impulse more prominent than RV -+thrill if restrictive VSD -Single S1 [sites.google.com]

Mitral Valve Insufficiency

Auscultation of heart sounds will reveal a loud, accentuated S1 early in mitral stenosis and soft S1 in severe mitral stenosis (see Heart Sounds Topic Review ). [healio.com]

When pulmonary hypertension develops, the P2 component of the S2 heart sound will be accentuated. [healio.com]

[…] the mitral valve leaflets become significantly more calcified, their mobility declines and they are unable to be separated a great deal, resulting in a soft or even absent S1 [healio.com]

Cervical Aortic Arch

Accentuated S1 & A2. Ejection click suggests bicuspid aortic valve. Murmur of coarctation: Best heard in the inter scapular region. [cardiologyforyou.blogspot.com]

Rheumatic Aortic Valve Obstruction

There is accentuation of the murmur just before S1, due to the increased pressure gradient when the LA contracts. EKG, electrocardiogram. [brown.edu]

Diminished or absent A2: The presence of a normal or accentuated A2 speaks against the existence of severe aortic stenosis Paradoxical splitting of the S2: Resulting from [emedicine.medscape.com]

[…] presence of left ventricular systolic dysfunction Hyperdynamic left ventricle: Unusual; suggests concomitant aortic regurgitation or mitral regurgitation Soft or normal S1 [emedicine.medscape.com]

Cardiac Dilatation

There is accentuation of the murmur just before S1, due to the increased pressure gradient when the LA contracts. EKG, electrocardiogram. [brown.edu]

Congenital Pulmonary Veins Atresia or Stenosis

The first heart sound (S1)is single and may be accentuated. The 2nd heart sound (S2) is usually single. [merckmanuals.com]

Cor Biloculare

Auscultation, revealed accentuated P2 and soft S1 with pansystolic murmur at the apex conducted to axilla. [de.slideshare.net]

Polyserositis

SENSORY SYSTEM-COULD NOT BE TESTED CEREBELLUM-COULDN’T BE TESTED GAIT-HEMIPARETIC GAIT CVS - S1S2 +,S1 VARIABLE,MDM + APEX WITHOUT PRESYSTOLIC ACCENTUATION RS - NVBS+ BS DIMINISH [slideshare.net]

Heart Valve Disease

S1, and an opening snap followed by a diastolic rumble with presystolic accentuation heard best at the apex in the left lateral decubitus position. [ncbi.nlm.nih.gov]

[11] Symptoms of mitral stenosis increase with exercise and pregnancy[11] On auscultation of a patient with mitral stenosis, typically the most prominent sign is a loud S1 [en.wikipedia.org]

Classification of Mitral Stenosis Severity Physical Examination Classic physical examination findings in patients with MS include a normal apical LV impulse, an accentuated [ncbi.nlm.nih.gov]

Pulmonary Edema

Mitral stenosis produces a low pitched, rumbling diastolic murmur associated with an opening snap at the apex which accentuates on expiration and produces loud S1. [ncbi.nlm.nih.gov]

Mitral regurgitation produces a blowing, high pitched pan-systolic murmur best heard at the apex, radiating to left axilla and accentuating on expiration, produces soft S1 [ncbi.nlm.nih.gov]

Hydropericardium

Physical Examination Right ventricular lift; palpable S1; opening snap (OS) follows A2 by 0.06 – 0.12 s; OS – A2 interval inversely proportional to severity of obstruction [curiozitatimedicale.blogspot.com]

Diastolic rumbling murmur with presystolic accentuation in sinus Complications : Hemoptysis, pulmonary embolism, pulmonary infection, systemic embolization; endocarditis is [curiozitatimedicale.blogspot.com]

Aortic Valve Stenosis

Diminished or absent A2: The presence of a normal or accentuated A2 speaks against the existence of severe aortic stenosis Paradoxical splitting of the S2: Resulting from [emedicine.medscape.com]

Cardiac Myxoma

Note loud S1 and S2. Additional late systolic sound is also present. This patient had severe pulmonary hypertension; that is why S2 was accentuated. [cardiacauscultation.com]

Right Atrial Myxomas Right atrial myxomas are associated with a loud, early systolic, widely split S1 due to expression of the tumour from the right ventricle. [atlasgeneticsoncology.org]

A pulmonary ejection murmur with a delayed and accentuated pulmonic second sound may be heard. There may also be an early, late or prolonged diastolic murmur heard. [atlasgeneticsoncology.org]

Cor Triatriatum

Auscultation, revealed accentuated P2 and soft S1 with pansystolic murmur at the apex conducted to axilla. [de.slideshare.net]

Hypertensive Heart Disease

S1 is normal in intensity and character. [emedicine.medscape.com]

S2 at the right upper sternal border is loud because of an accentuated aortic component (A2); it can have a reverse or paradoxical split due either to increased afterload [emedicine.medscape.com]

Scarlet Fever

[11] Symptoms of mitral stenosis increase with exercise and pregnancy[11] On auscultation of a patient with mitral stenosis, typically the most prominent sign is a loud S1 [en.wikipedia.org]

Another finding is an opening snap followed by a low-pitched diastolic rumble with presystolic accentuation.[11][10] The opening snap follows closer to the S2 heart tone with [en.wikipedia.org]

Dilated Cardiomyopathy Type 1NN

[11] Symptoms of mitral stenosis increase with exercise and pregnancy[11] On auscultation of a patient with mitral stenosis, typically the most prominent sign is a loud S1 [en.wikipedia.org]

Another finding is an opening snap followed by a low-pitched diastolic rumble with presystolic accentuation.[11][10] The opening snap follows closer to the S2 heart tone with [en.wikipedia.org]

Acute Aortic Regurgitation

[…] of the mitral valve. • A2 –normal or accentuated when AR is due to aortic root disease. • S2- absent or single or paradoxical splitting • S3 GALLOP - due to increased LV [slideshare.net]

Physical findings Inspection and palpation • Evidence of LVH • Heaving apex • Apex displaced to the left and downward Auscultation • S1- may be soft due to premature closure [slideshare.net]

Dilated Cardiomyopathy Type 1R

[11] Symptoms of mitral stenosis increase with exercise and pregnancy[11] On auscultation of a patient with mitral stenosis, typically the most prominent sign is a loud S1 [en.wikipedia.org]

Another finding is an opening snap followed by a low-pitched diastolic rumble with presystolic accentuation.[11][10] The opening snap follows closer to the S2 heart tone with [en.wikipedia.org]

Dilated Cardiomyopathy Type 2B

[11] Symptoms of mitral stenosis increase with exercise and pregnancy[11] On auscultation of a patient with mitral stenosis, typically the most prominent sign is a loud S1 [en.wikipedia.org]

Another finding is an opening snap followed by a low-pitched diastolic rumble with presystolic accentuation.[11][10] The opening snap follows closer to the S2 heart tone with [en.wikipedia.org]