Abe Ravin - #2- Splitting Of Sounds & Second Heart Sound album
Under normal conditions, the second heart sound splits with respiration.
Abe Ravin – Splitting Of Sounds & Second Heart Sound. Label: Merck, Sharp & Dohme – MSD-291. Splitting Of Sounds & Second Heart Sound Side 2. Companies, etc. Manufactured By – RCA Custom. Matrix, Runout (A-side matrix): TL4M-5862.
The second heart sound (S2) is created by the closing of the aortic valve and the closing of the pulmonic valve. The difference in timing between the closure of the aortic and pulmonic valves creates a split second heart sound. Careful analysis of the splitting and intensity of the second heart sound can indicate the presence of many cardiac abnormalities. In this example splitting varies between zero and eighty milliseconds depending on the phase of the respiratory cycle. In paradoxical splitting the maximum separation occurs at peak expiration. Paradoxical splitting can occur with left bundle-branch block (LBBB) and aortic stenosis both of which cause the aortic valve closure to be delayed until after the pulmonic valve closure, reversing the normal sequence of events.
Heart sounds are the noises generated by the beating heart and the resultant flow of blood through it. Specifically, the sounds reflect the turbulence created when the heart valves snap shut. In cardiac auscultation, an examiner may use a stethoscope to listen for these unique and distinct sounds that provide important auditory data regarding the condition of the heart.
The cardiac second sounds can provide a number of valuable clues to what is going on with the heart. What causes the split second heart sounds? There are believed to be multiple causes for the physiologic splitting of S2. Both A2 and P2 close when the pressure above the respective valves are greater than the pressure in the ventricles below. Given the lower vascular resistance of the pulmonary artery, during inspiration, the pulmonary artery is able to tolerate more volume of blood before the pressure above the valve increases. Additionally, during inspiration, more blood fills the right ventricle leading to a slightly longer ejection time, adding to the delayed pulmonic valve closure.
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Therefore, the A2 sound is the main component of S2. CLINICAL PEARL: A split S2 is best heard at the pulmonic valve listening post, as P2 is much softer than A2. Like the S1 heart sound, the S2 sound is described regarding splitting and intensity. S2 is physiologically split in about 90% of people.
The second heart sound remains unchanged through inspiration and expiration at sixty milliseconds. The murmurs have been eliminated in this lesson so that you can concentrate on the fixed splitting of the second heart sound.
Splitting of S1. Second heart sound (S2). Genesis, timing, and location. Factors determining the intensity of S2. Splitting of S2. Single S2. Third (S3) and fourth (S4) heart sounds. Many stethoscopes have a separate bell and diaphragm. The bell is most effective at transmitting lower frequency sounds, while the diaphragm is most effective at transmitting higher frequency sounds.
|A||Splitting Of Sounds & Second Heart Sound Side 1|
|B||Splitting Of Sounds & Second Heart Sound Side 2|
- Manufactured By – RCA, S.A. DE C.V.