You are incorrect - our patient's second sound at the upper left sternal edge is single in expiration and split in inspiration.


Your choice: Persistent expiratory splitting

This is a graphic example of a second heart sound that is minimally split in expiration and more widely split in inspiration. Persistent splitting throughout the respiratory cycle with normal inspiratory prolongation can be a normal finding in children and young adults, particularly with the patient supine. This finding typically disappears when the patient sits or stands.