Fixed Split Second Heart Sound

This is a video that describes the fixed split second heart sound. We also show you a real patient with this.

The Stanford Medicine 25 program for bedside medicine at the Stanford School of Medicine aims to promote the culture of bedside medicine to make current and future physicians and other healthcare provides better at the art of physical diagnosis.

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[moooooo]

FINALLY! A video that actually plays the audio of a split S2 instead of only describing the physiology

[amoghavarshanrupatunga]

Take away points

1) To hear Splitting of S2, Auscultate in "PULMONARY AREA"

(Because in other areas normally only A2 will be heard)

2) Normal Physiological Splitting can be appreciated during - "INSPIRATION"
d/t increased venous return to Right side of heart leading to delayed closure of Pulmonary Valve

3) Pathological FIXED SPLIT S2 heard in
-Pulmonary Hypertension
-RV Failure
-ASD

4) Heard as "Lub daa dub"

[jrperezdo]

Pulmonary hypertension will give you persistent splitting which varies with respiration, only an ASD will give you truly FIXED splitting

[metbumana]

How do you record heart sounds?That’s so great

[mohitjaiswal]

Also in TAPVC fixed split is seen with cyanosis

[sirranhaal]

These Stanford med videos are very useful but that damn fiddle is unsufferable

[xyz]

How to differentiate with s3 or opening snap

[Rasha.Ishtar]

How can we differentiate a fixed splitting of S2 from S3

[MOHAME]

if Any one has a video about normal heart sounds give me the link please

[nswetenham]

Nice explanation, but the heart sounds are a poor quality recording - all I hear is machine-like noise, I can't distinguish S1 from S2, let alone hear the splitting

[kaustavdutta]

My book says S2 can also be found in VSD and this isn't wrong

Then you didn't mentioned about VSD in your video.. may I know why ?

[nsindisomkhize]

Aortic and pulmonary valves dnt normally close at the same time, reason being the effect of systemic Bp o
ver the oartic.

[rumit]

can this finding help in diagnosing a PE?

[wholeNwon]

Listen carefully: To my ears, the split of S2 is not really fixed but is persistent. So, let's see the phono.

[SOLDbyYOU]

"What you should be hearing" .... is " A GODDAMN pulse sound compared back to back with an abnormal heart sound"

[Dragon-Slayr]

Truly is heart breaking to see how evil people are, not realising that I need to be in love to open portals. ( a safety mechanism to make sure the world is in a good place before we evolve) 🤣 dumb bastards