s1- mit tri soft:regurg,or valcve no close....loud:stenosis.

ms,ts(spring shut),v
entriclcontrctng harder high pressre
ex:anemia, hyeprtophy, hypertens
due to Hvolme,rhematic fev, excersizeepi.ne,
OPENING SNAP
s2- soft: ar, pr, not presnt aotic atresia
igh pressue in fron of valv

loud: stenosi valve is stiff, or h

ex: execrsie, tuners coarti, ren

al a. stenosi, cor pulmon, sitting down, pul edema
EJECTIN CLICK
s2 split-^^^inc o2, inc rv vol, delayopenclose
ex: inspir, asd l-r, pregncy(morevol), pulstenois, squat
(vol up), cooldownafteexercise
right..inspir left-expir
s2 narrow:pulm fibrosi(bleomycn,lupus--hypoxia), p.emb-d
ec o2, p.edem-decr o2(less vol comin in now bc backd up),
x
s3 noncompliant ventricle: 1-vol overload, 2-dil ventcle, 3-decompnstion(lose
contratil)
normal only in adolencnt female(estrogen is muscl relaxnt) "splash" in l
v
estrogenmcauses liver prodc proteins: hi
gh esr crp, lipoprot, tbg, angiotens, clotin fac fibrogn
s4
rights side low pres, resitnace open first, close 2nd
eisenmong- l-r shunt, pulm hypertne, reverse

open snap..valve pop open during diastolsi..stenosis: tri, mitr

ejection click..(st seg)...pop valve open systole: aortic pulm
midsystolic click...mvp,, buckling bulgin high velocit upward. not regurg,,7%wom
an estrogen
less vol in ventricle, need to contract harder, prolapse quicker, mov
er closr to s1
closerto s1 when standing, closer s2 when lying down
less vol Lventr(by standign up-blood pool to feet) contr
act faster