Cadiac Auscultation - Apex Sounds

You are incorrect - the best description of the heart sounds at the apex in our patient is two mid-systolic clicks.

Your choice: S1 + S2 + opening snap (OS)



This is a graphic example of an opening snap. Note that the opening snap occurs in early diastole and is high frequency.

The opening snap is a high frequency sound that is related to the opening of a stenotic but mobile mitral valve. The second heart sound-opening snap interval may be up to twelve hundredths of a second. The opening snap is associated with a loud first sound and the diastolic murmur of mitral stenosis.