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Second sound - abnormal splitting
Splitting may be widened, fixed, absent or reversed (paradoxic).
Most commonly helpful is probably paradoxic.
Most useful diagnostically is probably wide and fixed.
Wide splitting of S2
Definition: Remains split throughout respiratory cycle.
“Never” becomes single with expiration
May or may not vary perceptibly with respiration.
Is due to late P2 or early A2.
Can have electrical and mechanical causes.
Disclaimer:
Material is for discussion & review and is not advice or endorsement. Comments to
Donald Vine MD
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