Second Heart Sounds Second Heart Sound: Fixed Splitting, Decreased Aortic Intensity 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. play pause Position: Pulmonic Chestpiece: Diaphragm Maneuver: Sitting Phonocardiogram Cardiac Animation Table of Contents 1Second Heart Sound - Physiologically Split #2 2Second Heart Sound with Persistent Splitting 3Second Heart Sound with Fixed Splitting 4Second Heart Sound: Fixed Splitting, Increased Aortic Intensity 5Second Heart Sound: Fixed Splitting, Decreased Aortic Intensity 6Second Heart Sound and Late Systolic Click 7Second Heart Sound and a Tumor Plop 8Opening Snap and Second Heart Sound Practice Drill