Widened Splitting

Widened splitting of S2 refers to an increased time interval between the aortic (A2) and pulmonary (P2) components, such that there are two distinct sounds produced (even during expiration, and more widely separated still during inspiration).

Widened splitting is usually the result of a delayed closure of the pulmonary valve, as occurs in both right bundle branch block (RBBB) and valve stenosis (abnormal narrowing).

 

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