BOF: 27
A 16-year-old male has been
referred by his GP for investigation of a murmur. On examination he has a soft
systolic murmur in the pulmonary area and fixed splitting of the second heart
sound.
In which of the following
conditions does fixed splitting of the second heart sound occur:
a)
Atrial septal defect
b)
Patent ductus arteriosus
c)
Right bundle branch block
d)
Left bundle branch block
e)
Pulmonary stenosis
Answer:
a)
Fixed splitting of the second
heart sound is a feature of atrial septal defect.
(See ACES for PACES page 206)
Varying splitting of the second
heart sound may occur in right bundle branch block and pulmonary stenosis
(See ACES for PACES page 206)
Reversed splitting of the
second heart sound may occur in left bundle branch block and patent ductus
arteriosus (See ACES for PACES page 207)
Last Updated: 15/04/06
