Second Heart Sound - Physiologically Split #2 Auscultation Lesson with Recordings
Virtual Auscultation
The patient's position is supine.
Lesson
The second heart sound (S2) is created by the closing of the aortic valve followed by the closing of the pulmonic valve. Careful analysis of the splitting and intensity of the second heart sound can indicate the presence of many cardiac abnormalities. This example shows normal physiological splitting of the second heart sound. Splitting varies between zero and eighty milliseconds depending on the phase of the respiratory cycle. The aortic component of S2 (S2A) precedes the pulmonic component (S2P).Waveform
Heart Sounds Video
Authors and Sources
Authors and Reviewers
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Heart sounds by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient.
- Lung sounds by Diane Wrigley, PA
- Respiratory cases: William French
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David Lieberman, Audio Engineering
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Heart sounds mentorship by W. Proctor Harvey, MD
- Special thanks for the medical mentorship of Dr. Raymond Murphy
- Reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.
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Last Update: 12/11/2022
Sources
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Heart and Lung Sounds Reference Library
Diane S. Wrigley
Publisher: PESI -
Impact Patient Care: Key Physical Assessment Strategies and the Underlying Pathophysiology
Diane S Wrigley & Rosale Lobo - Practical Clinical Skills: Lung Sounds
- Essential Lung Sounds
Diane S. Wrigley, PA-C
Published by MedEdu LLC - PESI Faculty - Diane S Wrigley
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Case Profiles in Respiratory Care 3rd Ed, 2019
William A.French
Published by Delmar Cengage - Essential Lung Sounds
by William A. French
Published by Cengage Learning, 2011 - Understanding Lung Sounds
Steven Lehrer, MD
- Clinical Heart Disease
W Proctor Harvey, MD
Clinical Heart Disease
Laennec Publishing; 1st edition (January 1, 2009)