Ejection Click
An ejection click is an early systolic sound, and occurs when an abnormal aortic or pulmonic valve (eg, bicuspid aortic valve) opens, or from ejection of blood into a dilated great vessel (aorta or pulmonary artery, such as in pulmonary hypertension). The sound is close to S1 and can sound like an S1 split. However, an ejection click is best appreciated over the aortic and pulmonic valves (base of the heart), as opposed to the split S1 which is best heard over the apex of the heart.
Patient 1:
This young woman was admitted to the hospital for symptoms related to severe primary pulmonary hypertension, a common cause of an ejection click.
Ejection Click
Annotated
Patient 2:
This is a middle-aged woman with severe primary pulmonary hypertension. Note the ejection click as well as the split S2.
Ejection Click
Annotated
Patient 3:
This is a young man with sickle cell anemia with associated pulmonary hypertension.
Ejection Click
Annotated
Patient 4:
This patient has an ejection click.
Ejection Click
Annotated
Patient 5
This is a middle-age man with sickle cell disease complicated by severe pulmonary hypertension. Note the extra sound after S1 (ejection click