Cardiac Exam - Auscultation - ULSE
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You are incorrect - the best description of our patient's second heart sound at the upper left sternal edge is paradoxic splitting.

Your choice: Spli in inspiration, 1stcomponent louder

This is a graphic example of wide, inspiratory splitting of S2 in which the first component, A2, is louder than the second component, P2.

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Inspiratory splitting A2 > P2 Graphic
This is a graphic example of normal inspiratory, or physiologic, splitting of S2 in which the first component, A2, is normally louder than the second component, P2.

Discussion
The normal respiratory variation of the second heart sound, that is, inspiratory splitting, is attributable to two mechanisms: changes in venous return and changes in pulmonary vascular compliance.