Paradoxic Splitting of the Second Heart Sound in Systemic Hypertension

Three cases of paradoxic splitting of the second heart sound in elderly hypertensive patients are presented. It would appear that in arterial hypertension this phenomenon is not so unusual as has been previously supposed. Its mechanism of development is obscure, but independent factors or the long-term myocardial consequences of the hypertensive state seem to be more frequently operative than an elevated aortic pressure per se in the production of this abnormality.