Second Heart Sound with Fixed Splitting
Virtual Auscultation
        
The patient's position is supine.
Lesson
This example shows fixed splitting of the second heart sound. The second heart sound remains unchanged through inspiration and expiration at sixty milliseconds. Fixed splitting of the second heart sound (along with murmurs) indicates the presence of an Atrial Septal Defect, a congenital heart defect in which the intra-atrial septum is incomplete resulting in a hole between the left and right atria. The murmurs have been eliminated in this lesson so that you can concentrate on the fixed splitting of the second heart sound. In a later lesson you will hear the fixed splitting of S2 along with the murmurs of Atrial Septal Defect.Waveform
Heart Sounds Video
Authors and Sources
Authors and Reviewers
- 
                    Heart sounds by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient.
 - Lung sounds by Diane Wrigley, PA
 - Respiratory cases: William French
 - 
                    David Lieberman, Audio Engineering
 - 
                    Heart sounds mentorship by W. Proctor Harvey, MD
 - Special thanks for the medical mentorship of Dr. Raymond Murphy
 - Reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.
 - 
                    Last Update: 12/11/2022 
 
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
 - Essential Lung Sounds
                    Diane S. Wrigley, PA-C
Published by MedEdu LLC - 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)