Which technique helps to hear S2 splitting more clearly?

Using the bell with light pressure over the 2nd left intercostal space is an effective technique to enhance the audibility of S2 splitting. The bell is particularly useful for hearing lower-frequency sounds and certain heart sounds due to its design, allowing it to pick up softer, low-pitched sounds more effectively than the diaphragm.

S2 splitting occurs during inspiration when the aortic and pulmonic valves close at slightly different times. Placing the bell lightly over the 2nd left intercostal space, which is the area where the pulmonic valve is best auscultated, allows for optimal detection of the slight delays in closure of the valves as thoracic pressure changes with breathing.

Other techniques may not provide the same clarity because they might focus on different areas of the heart or utilize the diaphragm, which is better suited for higher-frequency sounds but can sometimes obscure the subtle nuances of S2 splitting. Particularly, using the diaphragm too firmly or in less optimal locations can hinder the assessment of these heart sounds, making them less audible and clear.