Physiology · Cardiac Physiology (Cycle, Output, ECG, Electrophysiology)

A 28-year-old woman with severe mitral stenosis is auscultated at the apex. A high-pitched, snapping sound is heard shortly after the second heart sound (S2). This sound is produced by which mechanism?

  • A Turbulent flow across a stenotic valve during systole
  • B Tensing of the stenotic valve leaflets during early diastole
  • C Rapid ventricular filling hitting a non-compliant ventricle
  • D Atrial contraction against a stiff ventricle
Correct answer: B. Tensing of the stenotic valve leaflets during early diastole

Explanation

An opening snap occurs when the doming, stenotic mitral valve leaflets suddenly tense and halt their opening motion in early diastole. Option A describes a systolic murmur. Option C describes an S3 gallop. Option D describes an S4 gallop. The snap is high-pitched and occurs shortly after S2.

Reference: Bates' Guide to Physical Examination, 13th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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