S1 is normal.
S2 may be normal or paradoxical splitting of S2 may be present as Aortic stenosis increases in severity, LV systole may be prolonged so a2 and P2 may become synchronous, or aortic valve closure may sometimes follow pulmonic valve closure, resulting in paradoxical splitting of S2 .
A2 may be heard in patients with Aortic stenosis who have pliable valves calcification diminishes the intensity of A2.
S4 may be audible at the apex and it reflects the presence of LV hypertrophy and an elevated LV end-diastolic pressure.
S3 occurs late in the course,as LV dilates and severe systolic dysfunction occurs.
S2 may be normal or paradoxical splitting of S2 may be present as Aortic stenosis increases in severity, LV systole may be prolonged so a2 and P2 may become synchronous, or aortic valve closure may sometimes follow pulmonic valve closure, resulting in paradoxical splitting of S2 .
A2 may be heard in patients with Aortic stenosis who have pliable valves calcification diminishes the intensity of A2.
S4 may be audible at the apex and it reflects the presence of LV hypertrophy and an elevated LV end-diastolic pressure.
S3 occurs late in the course,as LV dilates and severe systolic dysfunction occurs.
