Cadiac Auscultation - ULSE

You are incorrect - the best description of our patient's second heart sound at the upper left sternal edge is paradoxic splitting.

Your choice: Split in inspiration, 2nd component louder
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Inspiratory splitting P2 > A2 Graphic
This is a graphic example of splitting of S2 in which the second component, P2, is louder than the first component, A2.

Discussion
An abnormally loud pulmonary component of the second heart sound is typical of pulmonary hypertension.