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(c) The sound of the tricuspid valve closing may be louder in cases of hypertension. (d) S1 may be louder in patients with anemia, a fever, or hyperthyroidism, as well as patients with stenosis of their mitral valve. (e) Decreased S1 sounds can indicate: (1) Mitral valve subject to fibrosis or is calcified (2) Obesity (3) Emphysema (4) Cardiac ... ................
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