In a 5 year old child, instead of the physiological splitting of second hea sound which is expected only during inspiration, a wide and a fixed split of S2 is heard during both inspiration as well as expiration. Wide fixed split of second hea sound can be seen in all of the following EXCEPT?
Correct Answer: Ventricular septal defect
Description: --> Normally, S2 is single during expiration & split during inspiration with louder A2 preceding P2 --> Wide splitting: - S2 splitting d/t early A2 or late P2 resulting in A2-P2 interval > 0.03 sec during expiration. If the splitting interval increases during inspiration, it is wide variable splitting of S2. Seen in Pulmonic stenosis Mitral regurgitation Ventricular septal defect If the interval is same in inspiration & expiration, it is wide & fixed splitting of S2. Seen in Atrial septal defect Right Bundle Branch Block Total Anomalous Pulmonary Venous Connection
Category:
Pediatrics
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