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Medicine

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Cardiology

Question
11 out of 19
 

Loud pulmonary component of second heart sound heard in (select two options) (DNB June 2009)



A Pulmonary hypertension
B TOF

C Eisenmenger’s syndrome
D Pulmonary stenosis

E AS

Ans. A

Pulmonary hypertension, C . Eisenmenger’s syndrome

Heart Sound

1. Single S2 – TOF, Truncus Arterious, Pulmonary Atresia, Tricuspid Atresia, Eisenmenger syndrome, Severe PS

2. Soft S2 – a. Calcific aortic valve b. Calcific pulmonary stenosis

3. Loud A2 – Systemic hypertension

4. Loud P2 – Pulmonary HT

5. S2 splitting – Normal (A2 – P2) interval 30 ms

a. Wide variable splitting ofS2 –RBBB, PS

b. Wide fixed splitting of S2 – Atrial septal defect.

6. Reverse/ Paradoxical splitting of S2 – P2 Precede A2, (Splitting is maximal in expiration and decrease during inspiration) LBBB, AS, WPW (Type B)

Extra Edge: WPW syndrome type B and RV pacing are associated with reversed splitting. WPW syndrome type A and LV pacing are not associated with reversed splitting.

Cardiology Flashcard List

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