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Hence, a patient with first degree heart block will typically have a soft first heart sound. For the same reasons a patient with variable PR interval (Mobitz I second degree AV block or third degree heart block) can have changing intensity of the first heart sound. Lyme carditis, anatomically corrected transposition and maternal lupus can all cause complete heart block.
Splitting of Second heart sound. Labels: clinical skills, medical high yield facts. In order to understand splitting of the second heart sound, knowledge of its relationship to the cardiac cycle is essential. To understand Splitting of S2 better, we should first understand its normal physiology. Second heart sound : It has two audible components, the aortic valve closure sound (A2) and the pulmonic valve closure sound (P2), which are normally split on inspiration and virtually single on expiration. Technique :