wide and fixed split of S2

wide and fixed split of S2

wide and fixed split of S2

[A] ASD
[B] VSD
[C] PDA
[D] TOF

wide and fixed split of S2

Why there is wide and fixed split of S2 in ASD?

1. wide and fixed split of S2
2. wide split of S2
   • Left to right shunt increases the flow to RV
   • RV volume overload cause delayed P2 – That causes wide split of S2
3. Fixed split – split doesnot vary with phases of respiration.
   • Normally inspiration increase flow to RV and expiration decreases
   • ASD – Left to right shunt at atrial level and systemic venous return vary reciprocally with respiration.
   • Inspiration – Systemic venous return increases and this leads to decrease in Left to right shunt
   • Expiration – Systemic venous return decreases and this leads to increase in Left to right shunt
   • So in both phases of respiration the RA volume remains same. That cause same RV volume at both phases of respiration which leads to fixed S2.
4. S2 split don’t vary with respiration

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