In auscultating the heart sounds of a patient with chronic hypoxemia, you notice a marked in-crease in the intensity of the second heart sound (S2) and no splitting during inhalation
This finding is most consistent with which of the following?
a. Mitral insufficiency
b. Left ventricular hypertrophy
c. Tricuspid valve stenosis
d. Pulmonary hypertension
ANS: D
Pulmonary hypertension produces an increased intensity of S2. This sound is referred to as a loud P2 and is a result of more forceful closure of the pulmonic valve.
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