Persistent Splitting S2 Lesson

patient thorax when auscultating by stethoscope

patient position during auscultation
The patient was supine during auscultation.

Description

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

Phonocardiogram

Anatomy

Persistent Splitting S2


Authors and Sources

Authors and Reviewers

Sources

  • Heart and Lung Sounds Reference Library Diane S. Wrigley
    Publisher: PESI
  • Impact Patient Care: Key Physical Assessment Strategies and the Underlying Pathophysiology
    Diane S Wrigley & Rosale Lobo
  • Practical Clinical Skills: Lung Sounds
  • PESI Faculty - Diane S Wrigley
  • Case Profiles in Respiratory Care 3rd Ed, 2019
    William A.French
    Published by Delmar Cengage
  • Essential Lung Sounds by William A. French
    Published by Cengage Learning, 2011
  • Understanding Lung Sounds Steven Lehrer, MD
  • Clinical Heart Disease W Proctor Harvey, MD
    Clinical Heart Disease
    Laennec Publishing; 1st edition (January 1, 2009)
  • Heart and Lung Sounds Reference Guide
    PracticalClinicalSkills.com




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