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.
In healthy adults, there are two normal heart sounds often described as a lub and a dub (or dup), that occur in sequence with each heartbeat. These are the first heart sound (S 1) and second heart sound (S 2), produced by the closing of the AV valves and semilunar valves, respectively.