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Essential Heart Sounds

Split Second Heart Sound

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This lesson covers physiologic and paradoxical splitting of the second heart sound. As described earlier, the second heart sound is produced by the closing of the aortic valve and the closing of the pulmonic valve. These valves can close at slightly different times. This creates a split second heart sound. The second heart sound's splitting and intensity can indicate several types of cardiac abnormalities. In this recording, the splitting varies between zero and eighty milliseconds. The variation in splitting is a function of the respiratory cycle. In physiologic splitting the maximum separation between aortic and pulmonic components of the second heart sound occurs at peak inspiration. In paradoxical splitting the maximum separation occurs at peak expiration. Paradoxical splitting can occur with aortic stenosis and left bundle-branch block. Both of these abnormalities cause a delay in the aortic valve closure until after the pulmonic valve closure, reversing the normal sequence of events.




Split Second Heart Sound
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Table of Contents

            Introduction
1Normal First and Second Heart Sounds - No Splitting
2Reduced Intensity First and Second Heart Sounds
lesson completed 3Split Second Heart Sound
4Third Heart Sound (S3) Gallop
5Fourth Heart Sound (S4) Gallop
6Third and Fourth Heart Sound Gallop
7Summation Gallop at 120 beats per minute
8Fixed Splitting of Second Heart Sound
9Mid-Systolic Click
10Systolic Murmur - Aortic Stenosis
11Diastolic Murmur - Aortic Regurgitation
12Mitral Valve Leaflet Prolapse
13Pansystolic Murmur - Mitral Regurgitation
14Diastolic Murmur - Mitral Stenosis

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After this course, visit EasyAuscultation.com for additional heart sounds courses.

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