Examine the illustration and play the WAV file multiple times. It is more important to learn the cadence (pattern / timing) than the quality of the sounds at this point.
Remember and review the cardiac events as you listen. S2 is created when the ventricles relax and pressure from the aorta and pulmonary arteries exceeds the ventricular pressures. As a result the Aortic and Pulmonic valves close. Occasionally there is slight splitting of S2 especially during inspiration. If S2 is Widely split or Fixed (as this case demonstrates) it indicates disease.
Once you have the split S2 mastered, go on to the next case.
Updated: September 23, 1997