Paradoxical splitting of S2 is seen in: (A) Pulmonary stenosis, (B) Pulmonary hypeension, (C) Aoic stenosis, (D) Congenital absence of pulmonary valve
Answer is C. Paradoxical splitting: Reverse of normal physiology, splitting of second hea sounds during expiration, singular during inspiration Seen in conditions that cause delayed conduction down the left bundle (LBBB, pre-excitation of the right ventricle, right ventricular pacing, premature RV beats), aoic stenosis ref - Harrisons internal medicine 20e pg1802-1805