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Paradoxical splitting occurs when pulmonic valve (P2) closes before the aortic valve (A2). This causes second heart sound (S2) to be a single sound during inspiration and split during exhalation. Etiology delay in aortic closure: aortic stenosis, volume overload of left ventricle (LV), conduction defects in LV, and left bundle branch block (LBBB). In this(More)
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