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The lub-DUB of the heartbeat is caused by the closing of two separate pairs of valves, in response to heart muscle contractions. Turbulent blood flow occurs as blood pushes against the valves.

The first sound is caused by the closing of atrioventricular valves (mitral valve, tricuspid valve) that separate the upper chambers (atria) and lower chambers (ventricles) of the heart, as blood enters the ventricles.

The second sound is caused by the closing of the semilunar valves at the exit of the ventricles (the right ventricle having pumped blood into the pulmonary artery and the left ventricle having pumped blood into the aorta).

There are other specific heart sounds that occur, usually as a result of problems with the function of the heart.

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