THE MERCK MANUAL: The Merck Manual of Diagnosis and Therapymultimedia

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Cardiovascular Disorders

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Split 2nd Heart Sound With Atrial Septal Defect

Topics Containing This Multimedia

  • Cardiovascular Examination
  • Sound is that of fixed S2 splitting, ie, S1-A2-P2 at rest (“out”) and with inspiration (“in”). Splitting is fixed because the volume of flow through the right ventricle is increased, eliminating the normal delay in closure of the pulmonic valve associated with inspiration.

    Recording provided by Jules Constant, MD.

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