THE MERCK MANUAL: The Merck Manual of Diagnosis and Therapymultimedia

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  • Cardiovascular Examination
  • Split 2nd Heart Sound With Atrial Septal Defect

    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.