Mitral valve stenosis class III or IV symptoms. Once an individual develops NYHA class III or IV symptoms, the progression of the disease accelerates and the patient's condition deteriorates. Upon auscultation of an individual with mitral stenosis, the first heart sound is usually loud and may be palpable (tapping apex beat) because of increased force in closing the mitral valve. The first heart sound is made by the mitral and tricuspid heart valves closing. These are normally synchronous, and the sounds are termed M1 and T1, respectively. M1 becomes louder in mitral stenosis. It may be the most prominent sign. If pulmonary hypertension
History of beliefs about the human body about what he proposed as the discovery of the clitoris, stated that, "like a penis, "if you touch it, you will find it rendered a little harder and oblong to such a degree that it shows itself as a sort of male member." (There was much debate on the actual discovery of the clitoris between male European scientists and many claimed to have described it first: by dissecting the human body and writing down what was observed these European scientists could claim in their idea of the body that they had discovered or created new knowledge.) This one-sex model was