A North Carolina minister suffered unexplained, recurring attacks that puzzled top doctors. Physical clues and toxicology hinted at something sinister lurking close to home. Who—or what—was behind these mysterious and life-threatening episodes? From: Diagnosis: Unknown S2 Ep5 | Real Responders

9. Reversed Paradoxical Split of the Second Sound - Heart Sounds Collection #CCU_SOUND Paradoxical Split S2 A paradoxical split S2 heart sound occurs when the splitting is heard during expiration and disappears during inspiration — opposite of the physiologic split S2. A paradoxical split S2 occurs in any setting that delays the closure of the aortic valve including severe aortic stenosis and hypertrophic obstructive cardiomyopathy, or in the presence of a left bundle branch block. CLINICAL PEAR