{"id":3481,"date":"2020-05-31T18:33:52","date_gmt":"2020-06-01T01:33:52","guid":{"rendered":"https:\/\/up.physicaldiagnosispdx.com\/up\/?page_id=3481"},"modified":"2021-12-21T12:24:06","modified_gmt":"2021-12-21T20:24:06","slug":"bronchophony","status":"publish","type":"page","link":"https:\/\/up.physicaldiagnosispdx.com\/up\/cardiology-multimedia-new\/bronchophony\/","title":{"rendered":"Opening Snap"},"content":{"rendered":"<div class=\"wpb-content-wrapper\">[vc_row][vc_column][vc_column_text]<span style=\"font-size: 14pt;\">The opening snap is a high-pitched sound in early diastole that occurs in the vast majority of patients with mitral stenosis. It coincides with the opening of the mitral valve. It generally occurs closer to S2 than the pericardial knock and the S3 gallop. It is best heard in the \u201csupramammary area\u201d \u2013 just above and slightly to the left of the nipple (or between the apex and the left sternal border).<\/span><br \/>\n<figure id=\"attachment_1658\" aria-describedby=\"caption-attachment-1658\" style=\"width: 150px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/up.physicaldiagnosispdx.com\/up\/cardiology-2\/card-tutorial\/#Opening_Snap\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-1658 size-thumbnail\" src=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/iconfinder_3_1250308-150x150.png\" alt=\"\" width=\"150\" height=\"150\" srcset=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/iconfinder_3_1250308-150x150.png 150w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/iconfinder_3_1250308-300x300.png 300w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/iconfinder_3_1250308.png 512w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/a><figcaption id=\"caption-attachment-1658\" class=\"wp-caption-text\">&nbsp;<\/figcaption><\/figure>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\n<h1 id=\"patient1\">Patient 1:<\/h1>\n<p><span style=\"font-size: 14pt;\">This is a young woman who grew up in Mexico and presented with a transient ischemic attack, severe flank pain from a renal embolism, and hemoptysis. She was found to have severe mitral stenosis. Note the loud S1 and opening snap.<\/span><\/p>\n<p><span style=\"font-size: 14pt;\">This patient also has a <a href=\"https:\/\/up.physicaldiagnosispdx.com\/up\/cardiology-2\/cardiology-multimedia-new\/3118-2\/#patient1\" target=\"_blank\" rel=\"noopener\">rumbling diastolic murmur<\/a> with presystolic accentuation when listening over the apex.<\/span>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1602644602386{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><strong><span style=\"font-size: 18pt;\">Opening Snap<\/span><\/strong><br \/>\n<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/463361789?loop=1\" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">&amp;amp;amp;amp;amp;lt;span data-mce-type=&#8221;bookmark&#8221; style=&#8221;display: inline-block; width: 0px; overflow: hidden; line-height: 0;&#8221; class=&#8221;mce_SELRES_start&#8221;&amp;amp;amp;amp;amp;gt;\ufeff&amp;amp;amp;amp;amp;lt;\/span&amp;amp;amp;amp;amp;gt;<\/iframe>[\/vc_column_text][vc_column_text][\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><strong><span style=\"font-size: 18pt;\">Annotated<\/span><\/strong><br \/>\n<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/468821675?loop=1 \" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">&amp;amp;amp;lt;span data-mce-type=&#8221;bookmark&#8221; style=&#8221;display: inline-block; width: 0px; overflow: hidden; line-height: 0;&#8221; class=&#8221;mce_SELRES_start&#8221;&amp;amp;amp;gt;\ufeff&amp;amp;amp;lt;\/span&amp;amp;amp;gt;<\/iframe>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\n<h1>Patient 2:<\/h1>\n<p><span style=\"font-size: 14pt;\">This is an older woman from Romania with severe mitral stenosis from rheumatic heart disease.<\/span>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1592017173859{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><strong><span style=\"font-size: 18pt;\">Opening Snap<\/span><\/strong><\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/620891348?loop=1\" width=\"640\" height=\"564\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><span style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" data-mce-type=\"bookmark\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p>\n[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><strong><span style=\"font-size: 18pt;\">Annotated<\/span><\/strong><\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/620890866?loop=1\" width=\"640\" height=\"564\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><span style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" data-mce-type=\"bookmark\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p>\n[\/vc_column_text][\/vc_column][\/vc_row]\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row][vc_column][vc_column_text]The opening snap is a high-pitched sound in early diastole that occurs in the vast majority of patients with mitral stenosis. It coincides with the opening of the mitral valve. It generally occurs closer to S2 than the pericardial knock and the S3 gallop. It is best heard in the<\/p>\n","protected":false},"author":9,"featured_media":0,"parent":3164,"menu_order":0,"comment_status":"open","ping_status":"closed","template":"page-templates\/page_PDXPDX-full-width.php","meta":{"nf_dc_page":"","_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"class_list":["post-3481","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages\/3481","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/users\/9"}],"replies":[{"embeddable":true,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/comments?post=3481"}],"version-history":[{"count":2,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages\/3481\/revisions"}],"predecessor-version":[{"id":10950,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages\/3481\/revisions\/10950"}],"up":[{"embeddable":true,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages\/3164"}],"wp:attachment":[{"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/media?parent=3481"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}