Paradoxical splitting of S 2 is seen in ?: (A) ASD, (B) Mitral stenosis, (C) Severe pulmonary stenosis, (D) Severe aoic stenosis
Answer is D. As AS increases in severity, LV systole may become prolonged so that the aoic valve closure sound no longer precedes the pulmonic valve closure sound, and the two components may become synchronous, or aoic valve closure may even follow pulmonic valve closure, causing paradoxical splitting of S 2 ( Harrison&;s principle of internal medicine,18th edition,pg no. 1939)