Why does mitral regurgitation cause a split S2?

S2 is normally split because the aortic valve (A2) closes before the pulmonary valve (P2). The closing pressure (the diastolic arterial pressure) on the left is 80 mmHg as compared to only 10 mmHg on the right. This higher closing pressure leads to earlier closure of the aortic valve.

What causes wide split S2?

Wide splitting of S2 is caused either by a delay in the pulmonic component of S2 or by shortening of left ventricular systole with earlier occurrence of A2.

What is the abnormal heart sound best associated mitral regurgitation?

Mitral Regurgitation: Murmur: Blowing holosystolic murmur. Heard best at the apex….

• Low frequency rumbling mid-diastolic murmur, with presystolic component possible.
• Heard best at apex.
• Accentuated in left lateral decubitus position.

What is the physiological reason for splitting of the 2nd heart sound?

A split S2 is a finding upon auscultation of the S2 heart sound. It is caused when the closure of the aortic valve (A2) and the closure of the pulmonary valve (P2) are not synchronized during inspiration.

What produces S1 S2 heart sounds?

In healthy adults, there are two normal heart sounds, often described as a lub and a dub that occur in sequence with each heartbeat. These are the first heart sound (S1) and second heart sound (S2), produced by the closing of the atrioventricular valves and semilunar valves, respectively.

What is loud P2?

a loud P2 is heard in pulmonary hypertension. a loud P2 occurs in an atrial septal defect without pulmonary hypertension. This is caused by a sharp rise and fall of pulmonary arterial pressure. in thin-chested people with a forward projecting aorta.

Where is S2 heard best?

A2 is best heard at the aortic area (second right intercostal space); P2 is best heard at the pulmonary area. S2 is a high-pitched sound heard best with the diaphragm of the stethoscope. The intensity depends on valvular factors, the transvalvular gradient, mechanical factors, and size of the great vessels.

What is crescendo decrescendo murmur?

Crescendo: a murmur which increases in intensity. Decrescendo: a murmur that decreases in intensity. Crescendo-decrescendo: a murmur that initially increases in intensity, peaks, and then decreases in intensity.

What is A2 and P2 heart sounds?

The second heart sound (S2) is produced by the closure of the aortic and pulmonic valves. The sound produced by the closure of the aortic valve is termed A2, and the sound produced by the closure of the pulmonic valve is termed P2.

In which pathology accentuated second sound over aorta is observed?

Pathological splitting of S2 may be due to many causes: delayed activation of the right ventricle in right bundle branch block, left ventricular ectopic beats, a left ventricular pacemaker; or delayed pulmonic valve closure because of right ventricular volume overload associated with right ventricular failure.

What is A2 P2?

The Basics of Second Heart Sounds Aortic valve closure (A2) which happens first. Pulmonic valve closure (P2) which happens second.