Aortic ejection click

Note aortic ejection click in a patient with bicuspid aortic valve.

S1 sounds split with a loud, sharp second component. There is a soft mid-systolic murmur following the ejection sound.

• Aortic valve opens following isovolumic contraction of LV. Hence, the click follows closure of mitral valve (S1).
• It is a high frequency sound and heard best with diaphragm.