paradoxical splitting

[trgf]

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Could someone please explain the pathophysiology underlying paradoxical splitting? how would a left bundle branch block cause aortic valve closure before pulmonic closure. Also why should asd cause earlier closure of its valve as opposed to a pulmonic valve?

 

[XRanger]

Could someone please explain the pathophysiology underlying paradoxical splitting? how would a left bundle branch block cause aortic valve closure before pulmonic closure. Also why should asd cause earlier closure of its valve as opposed to a pulmonic valve?

In paradoxical splitting pulmonic valve closes before aortic valve (normally aortic valve closes first). If you have left bundle branch block, there is delay in LV depolarization so delayed contraction, so the RV will contract first and close its pulmonic valve first.