The splitting is best heard in the second left intercostal space and the left sternal edge. The pulmonary component of S2 is known as P2, whereas the aortic component is called A2. This is because of the lower pressures in the pulmonary circulation allowing the blood to continue flowing into the pulmonary artery after systole ends in the left ventricle. Normally the aortic valves close before the pulmonary valves close. Increased intensity is heard in systemic hypertension (aortic component) and pulmonary hypertension(pulmonary component). When compared with the first heart sound, S2 is shorter, softer and is slightly higher pitched. Although it is heard over the precordium, S2 is loudest at the base (left sternal edge).ĭecreased intensity heard in low cardiac output, calcified aortic stenosis, and aortic incompetence. ![]() The aortic component of the second sound (A2) Slightly precedes the pulmonic component (P2). The second heart sound (S2) occurs with the closure of the semilunar valves (aortic and pulmonary valves) and signals the end of systole. Its intensity is increased in mitral stenosis due to an increased left atrial pressure and decreases in low cardiac output conditions. You can hear S1 over all the precordium but its usually loudest at the apex. The mitral component of the first heart sound (M1) Slightly precedes the tricuspid component (T1), but you usually hear the two components fused as one heart sound. The first heart sounds (S1) occur with the closure of the atrioventricular valves (mitral and tricuspid valves) and thus it signals the beginning of systole. Normal Heart Sounds The first heart sounds (S1) ![]() In some instances, extra heart sounds may be heard, these are the third and fourth heart sounds and additional sounds known as heart murmursĮvents in the cardiac cycle generate sounds that can be heard on the surface of the chest wall. ![]() These are the first heart sound and second heart sounds. During auscultation, two normal heart sounds are heard from a person with a normal heart.
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