Reversed splitting of the second heart sound in arterial stenotic lesions.

The behavior of the splitting of the second heart sound was analyzed in 78 cases with peripheral arterial stenosis, including 51 of •gaortitis syndrome•h (Takayasu's arteritis). Reversed or paradoxical splitting was observed in 10 cases of aortitis syndrome and 1 case with renal artery stenosis. Frequent occurrence of the reversed splitting was observed in •gextensive •h form of aortitis syndrome (8 out of 18 cases, i.e. 44%). Correlative study disclosed that the reversed splitting was frequently associated with gallop rhythm and exaggerated •ga•h wave as well as systolic bulge in the precordial low-frequency tracing (particularly the apex cardiogram). Frequent coincidence between the reversed splitting and aortic regurgitation was observed in aortitis syndrome (8 out of 17 cases with aortic insufficiency). Cardiac enlargement on the chest roent-