Single second (2nd) heart sound
This may be present in:
- a calcified aortic stenotic valve
- pulmonary stenosis - here the P2 component may be soft
- Fallot's tetralogy
- Ebstein's anomaly
- pericardial effusion
- where pulmonary pressure approaches systemic blood pressure, for example in a large ventricular septal defect
- other causes eg obesity, pulmonary emphysema
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