Splitting of the second heart sound (S2) is normally most pronounced during which of the fol-lowing?
a. Exhalation
b. Breath holding
c. Inhalation
d. Forced exhalation
ANS: C
The normal splitting of S2 is increased during inhalation because of the decrease in intrathoracic pressure, which improves venous return to the right side of the heart and further delays pulmonic valve closure.
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