heart sounds (second, loud)

Last reviewed 01/2018

Loud second heart sounds can be loud A2 or a loud P2.

• loud A2 occurs in systemic hypertension where there is a dilated proximal aorta
  
  
• a loud P2 is heard in pulmonary hypertension
  
  
• a loud P2 occurs in an atrial septal defect without pulmonary hypertension. This is caused by a sharp rise and fall of pulmonary arterial pressure
  
  
• in thin-chested people with a forward projecting aorta

Reference:

• Kirby B (1993).Clinical examination of the heart. Medicine International, 21(8), 294-99.