This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: General anatomy, Subject name: Anatomy
[{'content': 'Paradoxical splitting of second hea sound Heard in \nSelect and explain. \nA. RBBB, B. ASD, C. VSD, D. LBBB', 'role': 'user'}, {'content': 'Answer: D \nExplanation: Ref Harrison 19 th ed pg 1447 Reversed or paradoxical splitting refers to a pathologic delay in aoic valve closure, such as that which occurs in patients with left bundle branch block, right ventricular pac- ing, severe AS, HOCM, and acute myocardial ischemia. With reversed or paradoxical splitting, the individual components of S2 are audible at end expiration, and their interval narrows with inspiration, the oppo- site of what would be expected under normal physiologic conditions.', 'role': 'assistant'}]