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Second Heart Sound: Fixed Splitting, Decreased Aortic Intensity

Virtual Auscultation

patient torso with stethoscope chestpiece
patient position during auscultation

The patient's position should be sitting.

Lesson

This example shows a second heart sound (S2) with fixed splitting and an aortic component with decreased intensity. Once again, we are using fixed splitting to help you hear the difference in intensity between the aortic and pulmonic components of S2. This pattern is seen in the presence of long-standing severe pulmonary hypertension where the pressure in the pulmonary artery is markedly increased. Note the increased thickness of the right ventricular free wall.

Waveform





Heart Sounds Video




Authors and Reviewers

Authored by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient. Medically reviewed by Dr. Barbara Erickson, PhD, RN, CCRN. Last Update: 11/28/2021

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