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MedSchool Forums USMLE QBank Patient develops sudden SOB. On auscultation, they have loud S2, narrow S2 splitting and S4 which increases with inspiration. Diagnosis?
Spoiler for Answer:
Pulmonary embolism. S4 = pressure overload. "on inspiration" = Left ventricle. "loud S2" = "slamming shut"; slamming shut + L ventricle = Pulmonary HTN. Sudden HTN = Pulmonary embolism!

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