Step 1

Pathology 13

A 19-year old woman presents to the clinic for a yearly physical examination. Her past medical history is unremarkable, and she does not take any medications. On physical examination, an S2 split is heard while auscultating over the pulmonic valve. The first sound in the split is louder than the second. The split persists on inspiration and expiration. The duration of the split is the same on both inspiration and expiration.

Which of the following is the most likely cause of this patient’s physical exam findings?

  • A) Aortic stenosis
  • B) Atrial septal defect
  • C) Hypertrophic obstructive cardiomyopathy
  • D) Mitral regurgitation
  • E) Right bundle branch block


Robert Li


Dr. Ted O'Connell