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.
Heart Sounds. Heart sounds are generated by the turbulance created by blood flowing through the heart, specifically when the heart valves close. Normal heart sounds can be characterized by a lub dub that occurs with a heart beat. The first heart sound (lub) occurs when the atrioventricular (AV) valves close and the second heart sound (dub) is heard when the semilunar valves close.