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Paradoxical splitting of the second heart sound

MedGen UID:
534376
Concept ID:
C0232236
Finding
Synonyms: Paradoxic split of second heart sound, S>2<; Paradoxical splitting of S2; Reverse split of second heart sound; Reverse Split S2 Heart Sound; Reversed splitting of S2; Reversed splitting of the second heart sound
SNOMED CT: Reverse split of second heart sound (57517007); Paradoxic split of second heart sound, S>2< (57517007)
 
HPO: HP:0031663

Definition

Normally, the aortic valve closure (A2) is followed by the pulmonic valve closure (P2) but the A2-P2 interval increases with inspiration and decreases with expiration. With paradoxical splitting, there is a delay in the closure of the aortic valve, so that A2 can follow P2; the individual components can be appreciated at the end of expiration and the interval narrows with inspiration (which is the opposite of the normal pattern). [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVParadoxical splitting of the second heart sound

Recent clinical studies

Etiology

Madiyono B, Oesman IN, Sastroasmoro S, Putra ST, Soelaeman EJ, Rachmad KB
Paediatr Indones 1989 Sep-Oct;29(9-10):199-208. PMID: 2631026
Alvares RF, Goodwin JF
Postgrad Med J 1986 Jun;62(728):545-51. doi: 10.1136/pgmj.62.728.545. PMID: 3774690Free PMC Article

Diagnosis

Al-Naami B, Al-Nabulsi J, Amasha H, Torry J
Med Biol Eng Comput 2010 Feb;48(2):177-84. Epub 2009 Nov 19 doi: 10.1007/s11517-009-0548-7. PMID: 19924461
Yazawa Y, Nagai T, Hayashi S, Shibata A, Miyatani N, Takasawa N
Jpn Heart J 1985 Sep;26(5):857-65. doi: 10.1536/ihj.26.857. PMID: 4087378
Shaver JA, O'Toole JD
Mod Concepts Cardiovasc Dis 1977 Mar;46(3):13-16. PMID: 840222
Zuberbuhler JR, Bauersfeld SR, Pontius RG
Am Heart J 1967 Dec;74(6):816-9. doi: 10.1016/0002-8703(67)90100-7. PMID: 4229247
GRAY IR
Br Heart J 1956 Jan;18(1):21-8. doi: 10.1136/hrt.18.1.21. PMID: 13284181Free PMC Article

Prognosis

Al-Naami B, Al-Nabulsi J, Amasha H, Torry J
Med Biol Eng Comput 2010 Feb;48(2):177-84. Epub 2009 Nov 19 doi: 10.1007/s11517-009-0548-7. PMID: 19924461

Clinical prediction guides

Al-Naami B, Al-Nabulsi J, Amasha H, Torry J
Med Biol Eng Comput 2010 Feb;48(2):177-84. Epub 2009 Nov 19 doi: 10.1007/s11517-009-0548-7. PMID: 19924461

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