You are auscultation your patient’s chest, and you notice that the S2 sound seem

Question

You are auscultation your patient’s chest, and you notice that the S2 sound seems to be “split”, meaning that you can hear two separate sounds. You can also hear a noticeable murmur during S2. Is the abnormality in the atrioventricular valves or the semilunar valves? How do you know? Explain? You are auscultation your patient’s chest, and you notice that the S2 sound seems to be “split”, meaning that you can hear two separate sounds. You can also hear a noticeable murmur during S2. Is the abnormality in the atrioventricular valves or the semilunar valves? How do you know? Explain?

Explanation / Answer

Normally we are able to hear 2 heart sounds - S1 and S2 (by using stethoscope). These 2 sounds are produced at different parts.of heart and have different character.

S1 - Due to closure of Mitral and Tricuspid ( which are Atrioventricular valve). It correspond to end of Diastole and begining of Systole.

S2 - Due to closure of PULMONARY and AORTIC valve (which are Semilunar Valves). It occurs at end of systole.

From this we can infer that if there is any problem in SEMILUNAR Valve then S2 will be affected ie pathology of Semilunar valve (Aortic and Pulmonary valve ) will affect S2.

Splitting of S2 - This can occur due to wide time difference between closure of Aortic and Pulmonary valve. It is present normally also during inspiration, but if splitting is heard during Expiration then it is pathological or it its time gap is wide.

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