Second Heart Sound with Fixed Splitting | #46
This example shows fixed splitting of the second heart sound. The second heart sound remains unchanged through inspiration and expiration at sixty milliseconds. Fixed splitting of the second heart sound (along with murmurs) indicates the presence of an Atrial Septal Defect, a congenital heart defect in which the intra-atrial septum is incomplete resulting in a hole between the left and right atria. The murmurs have been eliminated in this lesson so that you can concentrate on the fixed splitting of the second heart sound. In a later lesson you will hear the fixed splitting of S2 along with the murmurs of Atrial Septal Defect.Auscultation Sounds
Patient Recording
Patient Recording - Half Speed
Position
The patient's position should be supine.
Listening Tips
S2:Fixed splitting throughout respiratory cycleWaveform (Phonocardiogram)
Observe Cardiac Animation
Authors and Sources
Authors and Reviewers
- EKG heart rhythm modules: Thomas O'Brien.
- EKG monitor simulation developer: Steve Collmann
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12 Lead Course: Dr. Michael Mazzini, MD.
- Spanish language EKG: Breena R. Taira, MD, MPH
- Medical review: Dr. Jonathan Keroes, MD
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Heart sounds and mentorship: W. Proctor Harvey, MD
- Medical review: Dr. Pedro Azevedo, MD, Cardiology
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Last Update: 1/8/2023
Sources
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Electrocardiography for Healthcare Professionals, 5th Edition
Kathryn Booth and Thomas O'Brien
ISBN10: 1260064778, ISBN13: 9781260064773
McGraw Hill, 2019 -
Rapid Interpretation of EKG's, Sixth Edition
Dale Dublin
Cover Publishing Company -
12 Lead EKG for Nurses: Simple Steps to Interpret Rhythms, Arrhythmias, Blocks, Hypertrophy, Infarcts, & Cardiac Drugs
Aaron Reed
Create Space Independent Publishing -
Heart Sounds and Murmurs: A Practical Guide with Audio CD-ROM 3rd Edition
Elsevier-Health Sciences Division
Barbara A. Erickson, PhD, RN, CCRN - Clinical Heart Disease
W Proctor Harvey, MD
Clinical Heart Disease
Laennec Publishing; 1st edition (January 1, 2009) -
The Virtual Cardiac Patient: A Multimedia Guide to Heart Sounds, Murmurs, EKG
Jonathan Keroes, David Lieberman
Publisher: Lippincott Williams & Wilkin)
ISBN-10: 0781784425; ISBN-13: 978-0781784429 - Project Semilla, UCLA Emergency Medicine, EKG Training Breena R. Taira, MD, MPH
Second Heart Sound with Fixed Splitting | #46
