Table 7: Auscultation other sounds

Physical Finding Associated cardiac condition(s)
Early Systolic Clicks (Ejection Sounds)
High frequency systolic ejection clicks, 0.09 to 0.14 seconds after first heart sound (S1) Aortic stenosis (bicuspid aortic valve), pulmonary stenosis, pulmonary hypertension, dilated pulmonary artery, left ventricular outflow obstruction
Midsystolic Clicks (Nonejection sounds)
Medium-to-high frequency clicks, 0.17 to 0.27 seconds after S1 Mitral valve prolapse (& associated late systolic murmur), tricuspid valve prolapse, nonmyxomatous mitral valve disease, adhesive pericarditis, atrial myxoma, atrial septal aneurysms, left ventricular aneurysm
Early Diastolic Opening Snap (OS)
High-frequency sound, 0.04 to 0.12 seconds after second heart sound (S2) Mitral stenosis, tricuspid stenosis
Early-Mid Diastolic Tumor Plops
Low frequency sound, 0.04 to 0.12 seconds after S2 Atrial myxoma
Early-Mid Diastolic Pericardial Knocks
Pericardial knock, 0.06 to 0.14 seconds after S2 Constrictive pericarditis