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Wide S2 - Delayed P2 – Mechanical (RV)

• Massive PE
• Pulmonary hypertension with RV failure.
• Moderate to severe isolated pulmonic stenosis.

Wide S2 - Delayed P2 - Increased pulmonary compliance

• Atrial septal defect (pre- & post-operative).
• Idiopathic dilation of the pulmonary artery.
• Mild pulmonic stenosis.

Wide S2 - Early A2 – Shortened LV systole

• VSD
• Mitral regurgitation