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3 Normal
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You are incorrect - our patient's acoustic event(s) at the time of the first heart sound is a split S1.


Your choice: S1 + ejection sound (ES)
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This is a graphic example of an S1 followed by an ejection sound (ES).

Ejection sounds are early systolic high-frequency events that occur at the onset of systolic flow into the great vessels and are best heard at the aortic and pulmonary areas. They result from doming of a stenotic but mobile semilunar valve or from the initial systolic distention of a dilated great vessel.