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Second Heart Sound with Persistent Splitting G

Second Heart Sound with Persistent Splitting

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.


Auscultation Sound From Lesson

auscultation sound from lesson
waveform






Position

Patient position
The patient's position should be supine.

Listening Tips

S1:
Systole:
S2: Splitting varies with respiration
Diastole:


Observe


Second Heart Sound with Persistent Splitting

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