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(Circulation. 1955;11:378.)
© 1955 American Heart Association, Inc.

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The Opening Snap of the Tricuspid Valve: A Physical Sign of Tricuspid Stenosis

CHARLES E. KOSSMANN M.D.¹

¹ From the Cardiovascular Service, Lenox Hill Hospital; the Pathological Laboratories, Bellevue Hospital; and the Department of Medicine, New York University College of Medicine, New York.

In two patients with rheumatic heart disease a short, loud, high pitched, early diastolic, snapping sound was heard at or below and to the right of the xiphisternum. Except for the different area of audibility it was similar on auscultation to the opening snap of the mitral valve. Both patients showed clinical evidence of tricuspid as well as mitral and aortic valvular disease. There was hemodynamic evidence of tricuspid disease in one, and the other displayed tricuspid stenosis at necropsy. The abnormal sound was regarded as the opening snap of the tricuspid valve.