Second Heart Sounds

Fixed Splitting S2 Lesson #669

patient thorax when auscultating by stethoscope

The patient was supine during auscultation.

Description

This lesson and recording presents fixed splitting of the second heart sound. The S2 split is unchanged through inspiration and expiration at about sixty milliseconds.

Fixed S2 splitting is associated with acute pulmonary hypertension, pulmonary stenosis, and pulmonary emboli. Fixed splitting of the second heart sound along with murmurs can indicate the presence of an atrial septal defect, a congenital heart defect.

The murmurs have been eliminated in this recording so that you can concentrate on the fixed splitting of the second heart sound. In a later module you will hear the fixed splitting of S2 along with murmurs of atrial septal defect.

Phonocardiogram

Anatomy

Fixed Splitting S2

Authors and Sources

Authors and Reviewers

Heart sounds by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient.
Lung sounds by Diane Wrigley, PA
Respiratory cases: William French
David Lieberman, Audio Engineering
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.
Last Update: 11/10/2021

Sources

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
Essential Lung Sounds Diane S. Wrigley, PA-C
Published by MedEdu LLC
PESI Faculty - Diane S Wrigley
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