Second Heart Sound with Persistent Splitting | Auscultation #21 | Lesson with Audio
The patient was supine during auscultation.
Description
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.Phonocardiogram
Anatomy
Second Heart Sound with Persistent Splitting
Authors and Sources
Authors and Reviewers
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Heart sounds by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient.
- Lung sounds by Diane Wrigley, PA
- Respiratory cases: William French
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David Lieberman, Audio Engineering
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Heart sounds mentorship by W. Proctor Harvey, MD
- Special thanks for the medical mentorship of Dr. Raymond Murphy
- Reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.
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Last Update: 11/10/2021
Sources
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Heart and Lung Sounds Reference Library
Diane S. Wrigley
Publisher: PESI -
Impact Patient Care: Key Physical Assessment Strategies and the Underlying Pathophysiology
Diane S Wrigley & Rosale Lobo - Practical Clinical Skills: Lung Sounds
- PESI Faculty - Diane S Wrigley
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Case Profiles in Respiratory Care 3rd Ed, 2019
William A.French
Published by Delmar Cengage - Essential Lung Sounds
by William A. French
Published by Cengage Learning, 2011 - Understanding Lung Sounds
Steven Lehrer, MD
- Clinical Heart Disease
W Proctor Harvey, MD
Clinical Heart Disease
Laennec Publishing; 1st edition (January 1, 2009) -
Heart and Lung Sounds Reference Guide
PracticalClinicalSkills.com
