Second Heart Sound with Persistent Splitting

Unlock lessons, quizzes and more.

Sign Up

This example shows persistent splitting of the second heart sound. 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. With persistent splitting, the second heart sound is split in both inspiration and expiration although the degree of splitting is reduced in expiration.

This type of splitting is associated with Right Bundle Branch Block a condition in which the electrical signal which causes contraction of the right ventricle is blocked.
Second Heart Sound with Persistent Splitting
The recommended auscultation position for the stethoscope is the Pulmonic position. For this sound, use stethoscope's Diaphragm.


maneuver
The recommended patient position is Supine

Phonocardiogram

waveform
This waveform plots sound amplitude on the vertical axis against time on the horizontal axis.

Heart Animation

Lessons
left button        right button



Listening Tips
A synopsis of important sound features and timing for this abnormality.
S2: Splitting varies with respiration.
CaseID45
CourseID24
CourseCaseOrder2
ID33

This website is only for medical professional education. Contact a healthcare provider for medical care.

mededu company logo 2021 © Clinical Skills Education LLC. All Rights Reserved.