AS question

Cardiology

In aortic stenosis with regards to the second heart sound which of the following is true?

  • It does not “split”
  • There is splitting of the S2 P2 (pulmonary) and A2 (aortic)
  • There is reverse splitting of the S2

There is reverse splitting of the S2.

This is because normally the aortic valve shuts before the pulmonary valve. In severe AS, as the ventricle takes longer to empty, the valve takes longer to shut. Therefore there’s reversed or “paradoxical” splitting of S2.