Persistent Splitting S2 Lesson #668

patient thorax when auscultating by stethoscope

patient position during auscultation
The patient was supine during auscultation.


In this recording, we can observe S2 persistent splitting. Splitting varies between thirty milliseconds at peak expiration and sixty milliseconds at peak inspiration.

With normal physiologic splitting, the second heart sound is not split at peak expiration. But with persistent splitting, the S2 splits during inspiration and expiration. However, the amount of splitting is reduced in expiration.

This type of splitting is associated with pulmonary hypertension and right bundle branch block



Persistent Splitting S2

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