Midsystolischer

Midsystolischer, also known as midsystolic or P2 splitting, is a term used in cardiology to describe a specific auscultatory phenomenon observed during cardiac cycle analysis. It pertains to the timing and characteristics of heart sounds, particularly in relation to the splitting of the second heart sound (S2) during systole.

During normal respiration, the second heart sound, which results from the closure of the aortic and pulmonary valves, may exhibit slight variations in timing, known as physiological splitting. Midsystolischer splitting refers to a phenomenon where the split occurs predominantly during the middle or late part of systole, rather than at the beginning or end. This can be detected through careful auscultation as a distinct separation of the S2 components, often most prominent in certain positions or phases of the respiratory cycle.

This splitting can be caused by various cardiac conditions. It is commonly associated with pulmonary hypertension, right bundle branch block, or other right ventricular conduction delays, which delay closure of the pulmonary valve relative to the aortic valve. Conversely, it can also be a normal physiological variant in some individuals, especially during deep inspiration.

Understanding midsystolischer is important for clinical diagnosis, as it can provide clues about underlying hemodynamic changes or conduction delays within the heart. Its presence, timing, and variation with respiration help differentiate between physiological and pathological states, guiding further diagnostic and therapeutic decisions.