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.
They open to allow blood to move in one direction and close to keep blood from backing up. The first sound results from closure of the mitral and tricuspid valves, which separate the upper and lower chambers of the heart. The second sound occurs as a result of closure of the pulmonic and aortic valves. Blood travels across these valves on its way to the lungs and heart.