Abnormality | Causes |
Increased intensity | |
Atrioventricular valve obstruction | |
Mitral | Mitral stenosis and left atrial myxoma |
Tricuspid | Tricuspid stenosis and right atrial myxoma |
Increased transvalvular flow | |
Mitral | Patent ductus arteriosus; ventricular septal defect; atrial septal defect |
Tricuspid | |
Forceful ventricular systole | Hyperkinetic heart syndrome; tachycardia (eg, exercise); mitral valve prolapse |
Short PR interval | Pre-excitation syndrome; Lown-Ganong-Levine syndrome |
Decreased intensity | |
Immobility of mitral valve | Calcific mitral stenosis |
Lack of apposition of the mitral leaflets | Rheumatic mitral regurgitation |
Presystolic semiclosure of the atrioventricular valves | Long PR interval; acute aortic regurgitation; significant aortic stenosis; dilated cardiomyopathy |
Conduction anomaly | Left bundle branch block |
Wide splitting of S1 | |
Conduction abnormalities | Complete right bundle branch block; left ventricular pacing; pre-excitation syndrome (left ventricular connection); Ebstein's anomaly |
Mechanical | Tricuspid stenosis; atrial septal defect; Ebstein anomaly |
Reversed splitting of S1 | |
Arrhythmia | Premature beats (right ventricular origin) |
Mechanical | Severe mitral stenosis and left atrial myxoma |
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