In auscultating the heart sounds of a patient with chronic hypoxemia, you notice a marked increase in the intensity of the second heart sound (S₂) and no splitting during inhalation. This finding is most consistent with which of the following?

Question

Quizplus · Accepted Answer

The marked increase in the intensity of the second heart sound (S2) and absence of splitting during inhalation is consistent with pulmonary hypertension, as it causes an increased resistance to blood flow through the pulmonary artery resulting in higher pressure and thus closure of the pulmonary valve (P2) which produces S2. This can lead to hypertrophy of the right ventricle and eventually right-sided heart failure. The other options (mitral insufficiency, left ventricular hypertrophy, tricuspid valve stenosis) do not typically result in changes in the characteristics of S2.

In Auscultating the Heart Sounds of a Patient with Chronic