Paradoxical Splitting of the Second Heart Sound in Coronary Heart Disease

Abstract

DISTINCTIVE auscultatory findings in coronary disease are notably few, and any additional bedside clue to the diagnosis is of value. It seems pertinent to report our observations of paradoxical, or reversed, splitting of the second heart sound in 7 patients with proved coronary disease.Case ReportsR.G. (P.B.B.H. 2–22–65), a 70-year-old man, had been treated for an acute myocardial infarction elsewhere 8 years previously. Subsequently, he had episodic pain in the left side of the chest on exertion, relieved by rest or nitroglycerin. He was admitted to the hospital because of a marked increase in the severity of the chest . . .