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Which of the following items attenuates S1 heart sound?
A. PR interval prolongation
B. moderate MS
C. increase inotropic effect


I believe is B. moderate MS

Anything that increases ventricular volume without regurgitation will also increase S1 like inotropics. In the case of moderate mitral stenosis, blood volumen to the ventricle is decreased without regurgitation, thus attenuation of S1. An opening snap might be present. In severe MS, regurgitation might be an additional component which might even totally blunt S1. I hope I'm right.

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