According to The Hollywood Reporter, the four voice actors who make up the Family Guy cast -- Alex Borstein, Mila Kunis, Seth Green and Mike Henry -- has collectively negotiated a new salary between $175,000 and $225,000 per episode.
Hence, a patient with first degree heart block will typically have a soft first heart sound. For the same reasons a patient with variable PR interval (Mobitz I second degree AV block or third degree heart block) can have changing intensity of the first heart sound. Lyme carditis, anatomically corrected transposition and maternal lupus can all cause complete heart block.
There has been controversy about the origin of the components of the first heart sound. Proof that the first component is due to mitral closure stems from the fact that it is loudest in the mitral area, precedes the carotid upstroke and coincides with echocardiographic mitral valve closure.