Sounds of the heart in diastole

TLDR: In this paper, the authors discuss normal and abnormal ventricular filling sounds, opening snap, tumor plop, pericardial knock, prosthetic A-V valve click and pacemaker-induced sound.

Abstract: Cardiac diastole usually is acoustically silent even though several hemodynamic events take place in this phase of the cardiac cycle. In some healthy subjects and in many patients with cardiovascular alterations one or more “extra” heart sounds may be heard in diastole, and in them the distinction between normal and abnormal heart sounds must be established. In general, diastolic sounds may be spontaneous in nature or iatrogenic, that is, a consequence of replacement of the atrioventricular (A-V) valve with a caged-poppet prosthesis or a result of pervenous pacemaker implantation. The majority of the sounds emanate from the chambers of the heart. This presentation discusses normal and abnormal ventricular filling sounds, opening snap, “tumor plop,” pericardial knock, prosthetic A-V valve click and pacemaker-induced sound.