Abnormalities of the Intensity of the Second Heart Sound

The conditions that change the intensity of S2 are the following:

# Changes in systolic pressure

• Condition of the valve

Any condition that produces an increase in the systolic pressure increases the intensity of the S2. Conversely, conditions that lower the systolic pressure soften the S2. Hypertension raises aortic systolic pressure and produces a loud A2 component of S2.

Calcification or fibrosis of the semilunar valves produces a softening of their closure, S2. Because the semilunar valves are a morphologically different type of valve, fibrosis does not cause an increased intensity, as in closure of a fibrotic atrioventricular valve.

*Gradually increasing PR intervals until a dropped beat occurs.

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