title: Another confusing click. A prosthetic fourth heart sound.
abstract: A combined phonocardiographic and echocardiographic evaluation is presented of a patient with a mechanical prosthetic mitral valve. An intermittent sound equivalent to a prosthetic fourth sound is demonstrated and shown to be created by abrupt motion of the disc of the prosthesis with atrial systole.
mesh_terms: D004452:Echocardiography; D006326:Heart Auscultation; D006347:Heart Sounds; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D010701:Phonocardiography