Second Heart Sounds

Second Heart Sound: Fixed Splitting, Decreased Aortic Intensity Sounds

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This example shows a second heart sound (S2) with fixed splitting and an aortic component with decreased intensity. Once again, we are using fixed splitting to help you hear the difference in intensity between the aortic and pulmonic components of S2.

This pattern is seen in the presence of long-standing severe pulmonary hypertension where the pressure in the pulmonary artery is markedly increased.

Note the increased thickness of the right ventricular free wall.

Second Heart Sound: Fixed Splitting, Decreased Aortic Intensity

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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 Sitting

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, reduced intensity of aortic component.

CaseID	48
CourseID	24
CourseCaseOrder	5
ID	36