![]() ![]() Both of these abnormalities cause a delay in the aortic valve closure until after the pulmonic valve closure, reversing the normal sequence of events. Paradoxical splitting can occur with aortic stenosis and left bundle-branch block. ![]() In paradoxical splitting the maximum separation occurs at peak expiration. In physiologic splitting the maximum separation between aortic and pulmonic components of the second heart sound occurs at peak inspiration. The variation in splitting is a function of the respiratory cycle. second heart sound: the second sound heard on auscultation of the heart signifies the beginning of diastole and is due to closure of the semilunar valves. ![]() In this recording, the splitting varies between zero and eighty milliseconds. The second heart sound's splitting and intensity can indicate several types of cardiac abnormalities. These valves can close at slightly different times. Studies have demonstrated that the aortic valve shuts first, producing the first component of the second heart sound and the pulmonary valve the second component 2. Essential Heart Sounds Split Second Heart Sound This lesson covers physiologic and paradoxical splitting of the second heart sound.Īs described earlier, the second heart sound is produced by the closing of the aortic valve and the closing of the pulmonic valve. Physiologically split-second heart sound As discussed above, the second heart sound (S2) is physiologically split during inspiration but not during expiration. ![]()
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