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Split S2

Listen for splitting of this sound in the 2nd and 3rd left interspaces. Ask the patient to breathe quietly, and then slightly more deeply than normal. Does S2 split into its two components, as it normally does? If not, ask the patient to (1) breathe a little more deeply, or (2) sit up. Listen again. A thick chest wall may make the pulmonic component of Sj inaudible.

Width of split. How wide is the split? It is normally quite narrow.

See Table 7-3, Variations in the Second Heart Sound (p._).

When either A2 or P2 is absent, as in disease of the respective valves, S2 is persistently single.

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