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Yale University
School of Medicine
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New Haven, CT
06519 USA

Name: Physical Examination

General

A 64 year-old man looking 10 years younger than his age.

Vital signs

Temp 98.4 degrees; pulse 52 and regular; BP 130/84.

HEENT

Normal.

Neck

Jugular veins flat at 45 degrees.

Chest

Resonant, breath sounds normal.

Heart

Regular; PMI 5th ics mcl; S1 widely split, S2 normal, no gallops.

Abdomen

Soft and non-tender; no organomegaly or mass.

Extremities

Pulses all palpable, no edema.

The correct answer is True. The first component of the first heart sound is mitral closure and the second component is tricuspid closure. A delay in tricuspid closure causes the sounds to "split." What might delay tricuspid valve closure and cause wide splitting of the first heart sound?

Next: Test results