3 Normal
    Cardiac Exam - Auscultation ULSE
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You are incorrect - our patient's second sound at the upper left sternal edge is split in inspiration and the first component is louder.

Your choice: Wide, fixed splitting

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This is a graphic example of wide, fixed splitting of the second heart sound.

Fixed splitting of the second heart sound typically occurs in patients with atrial septal defect, because the common atrial reservoir negates the usual influence of respiration on venous return and there is a constant increase in right ventricular flow that delays pulmonary closure.