Loud pulmonary component of second heart sound heard in | PGI Nov 2017 Preparations MCQ

Loud pulmonary component of second heart sound heard in 

A. Pulmonary hypertension 
B.TOF 
C. Eisenmenger’s syndrome 
D. Pulmonary stenosis 
E. AS

Answer. A. Pulmonary hypertension ; (C) Eisenmenger syndrome

• Pulmonary hypertension: P, loud, normal splitting of S2

• TOF: P2 soft & delayed and is generally inaudible as pulmonary artery pressure is reduced and RV outflow obstruction is there. So, s2 is single, the audible sound is A2.

• Eisenmenger syndrome : P2 is loud as there is pulmonary hypertension

• Pulmonary stenosis: P2 is delayed & softer widely split with normal movement.

• Aortic stenosis : P2 is normal; A2 delayed normal splitting, single paradoxical splitting.