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Ejection click

MedGen UID:
548528
•Concept ID:
C0277911
•
Finding
Synonyms: Cardiac click sound on auscultation; EC - Ejection click
SNOMED CT: EC - Ejection click (3747008); Ejection click (3747008)
 
HPO: HP:0034421

Definition

A high-pitched sound that occurs at the moment of maximal opening of the aortic or pulmonary valves. They are heard just after the first heart sound. The sounds occur in the presence of a dilated aorta or pulmonary artery or in the presence of a bicuspid or flexible stenotic aortic or pulmonary valve. Ejection clicks may also be called ejection sounds. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVEjection click

Professional guidelines

PubMed

Appropriateness of use criteria for transthoracic echocardiography: are they relevant outside the USA?
Gurzun MM, Ionescu A
Eur Heart J Cardiovasc Imaging 2014 Apr;15(4):450-5. Epub 2013 Oct 22 doi: 10.1093/ehjci/jet186. PMID: 24154849
Normal reference ranges from 11 to 41 weeks' gestation of fetal left modified myocardial performance index by conventional Doppler with the use of stringent criteria for delimitation of the time periods.
Cruz-Martínez R, Figueras F, Bennasar M, García-Posadas R, Crispi F, Hernández-Andrade E, Gratacós E
Fetal Diagn Ther 2012;32(1-2):79-86. Epub 2012 Jul 3 doi: 10.1159/000330798. PMID: 22759646

Recent clinical studies

Etiology

Systolic ejection click versus split first heart sound: Are our ears deceiving us?
Hoeting NM, McCracken CE, McConnell M, Sallee D, Iannucci GJ, Oster ME
Congenit Heart Dis 2017 Jul;12(4):417-420. Epub 2017 Mar 16 doi: 10.1111/chd.12460. PMID: 28299882
Detection of systolic ejection click using time growing neural network.
Gharehbaghi A, Dutoit T, Ask P, Sörnmo L
Med Eng Phys 2014 Apr;36(4):477-83. Epub 2014 Mar 7 doi: 10.1016/j.medengphy.2014.02.011. PMID: 24613501
Chest pain in a young woman.
Click RL, Spittell JA Jr, Puga FJ
Mayo Clin Proc 1988 Apr;63(4):368-72. doi: 10.1016/s0025-6196(12)64859-9. PMID: 3352320
Prevalence of clinical mitral-valve prolapse in 1169 young women.
Procacci PM, Savran SV, Schreiter SL, Bryson AL
N Engl J Med 1976 May 13;294(20):1086-8. doi: 10.1056/NEJM197605132942004. PMID: 1256525
Pseudoejection sound in hypertrophic subaortic stenosis: an echocardiographic correlative study.
Sze KC, Shah PM
Circulation 1976 Sep;54(3):504-9. doi: 10.1161/01.cir.54.3.504. PMID: 985739

Diagnosis

Pathological discrimination of the phonocardiogram signal using the bispectral technique.
Berraih SA, Baakek YNE, Debbal SMEA
Phys Eng Sci Med 2020 Dec;43(4):1371-1385. Epub 2020 Nov 9 doi: 10.1007/s13246-020-00943-7. PMID: 33165819
Acquired Heart Disease Superimposed on Congenital Heart Disease.
Glancy DL
Am J Cardiol 2017 Nov 15;120(10):1903-1904. Epub 2017 Aug 12 doi: 10.1016/j.amjcard.2017.07.104. PMID: 28912039
Systolic ejection click versus split first heart sound: Are our ears deceiving us?
Hoeting NM, McCracken CE, McConnell M, Sallee D, Iannucci GJ, Oster ME
Congenit Heart Dis 2017 Jul;12(4):417-420. Epub 2017 Mar 16 doi: 10.1111/chd.12460. PMID: 28299882
The maverick heart sound.
Witt CM, Miranda WR, Newman DB
Heart 2016 Jul 1;102(13):1008. Epub 2016 Feb 26 doi: 10.1136/heartjnl-2015-309131. PMID: 26919867
Comparison of two educational interventions on pediatric resident auscultation skills.
Mahnke CB, Nowalk A, Hofkosh D, Zuberbuhler JR, Law YM
Pediatrics 2004 May;113(5):1331-5. doi: 10.1542/peds.113.5.1331. PMID: 15121949

Therapy

Pseudoejection sound in hypertrophic subaortic stenosis: an echocardiographic correlative study.
Sze KC, Shah PM
Circulation 1976 Sep;54(3):504-9. doi: 10.1161/01.cir.54.3.504. PMID: 985739

Prognosis

Acquired Heart Disease Superimposed on Congenital Heart Disease.
Glancy DL
Am J Cardiol 2017 Nov 15;120(10):1903-1904. Epub 2017 Aug 12 doi: 10.1016/j.amjcard.2017.07.104. PMID: 28912039
Childhood mitral valve prolapse.
Kavey RE
Pediatrician 1986;13(4):152-7. PMID: 3588448

Clinical prediction guides

Systolic ejection click versus split first heart sound: Are our ears deceiving us?
Hoeting NM, McCracken CE, McConnell M, Sallee D, Iannucci GJ, Oster ME
Congenit Heart Dis 2017 Jul;12(4):417-420. Epub 2017 Mar 16 doi: 10.1111/chd.12460. PMID: 28299882
Comparison of two educational interventions on pediatric resident auscultation skills.
Mahnke CB, Nowalk A, Hofkosh D, Zuberbuhler JR, Law YM
Pediatrics 2004 May;113(5):1331-5. doi: 10.1542/peds.113.5.1331. PMID: 15121949
A midsystolic ejection click.
Towne WD, Patel R, Cruz JB, Rathod R, Mirrer B
Chest 1980 Feb;77(2):223-6. doi: 10.1378/chest.77.2.223. PMID: 7353423
Echo-phonocardiographic and contrast studies in conditions associated with systemic arterial trunk overriding the ventricular septum: truncus arteriosus, tetralogy of Fallot, and pulmonary atresia with ventricular septal defect.
Assad-Morell JL, Seward JB, Tajik AJ, Hagler DJ, Giuliani ER, Ritter DG
Circulation 1976 Apr;53(4):663-73. doi: 10.1161/01.cir.53.4.663. PMID: 1253387
CONGENITAL AORTIC STENOSIS: SOME OBSERVATIONS ON THE NATURAL HISTORY AND CLINICAL ASSESSMENT.
PECKHAM GB, KEITH JD, EVANS JR
Can Med Assoc J 1964 Sep 19;91(12):639-43. PMID: 14201251Free PMC Article

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