What is reverse splitting of the heart sounds?
Reverse splitting of S2 is an abnormal heart sound. It occurs when pulmonary valve closes earlier than aortic valve. The delay in the closure of aortic valve produces reverse splitting. This abnormal sound produces during expiration but vanishes during inspiration. This happens because during inspiration the pulmonary valve moves closer to the aortic valve and narrows the splitting interval. Reverse splitting of S2 occurs in - Severe aortic stenosis - Hypertrophic Obstructive Cardiomyopathy (HOCM) - Left Bundle Branch Block (LBBB) -
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