Second Heart Sounds

Second Heart Sound with Fixed Splitting Sounds

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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.

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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

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

Heart Animation

Lessons

1	Second Heart Sound - Physiologically Split #2
2	Second Heart Sound with Persistent Splitting
3	Second Heart Sound with Fixed Splitting
4	Second Heart Sound: Fixed Splitting, Increased Aortic Intensity
5	Second Heart Sound: Fixed Splitting, Decreased Aortic Intensity
6	Second Heart Sound and Late Systolic Click
7	Second Heart Sound and a Tumor Plop
8	Opening Snap and Second Heart Sound

Practice Drill

Listening Tips
A synopsis of important sound features and timing for this abnormality.
S2: Fixed splitting throughout respiratory cycle.

CaseID	46
CourseID	24
CourseCaseOrder	3
ID	34