Split of second heart sound in Ventricular Septal Defect (VSD)

  • First you can review the Mechanism of normal split in second heart sound
  • In case of small ventricular septal defect, the blood flow through it is not large enough to cause a significant increase in right ventricular ejection time
  • Hence there is a normal split
  • But in case of large VSD, both the right ventricle and left ventricle act as a single chamber
  • The blood flow from both the ventricle occur for the same duration
  • Also because of the presence of pulmonary hypertension, hangout interval becomes negligible
  • Hence there is a single second heart sound with absent split in case of large VSD

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