Maneuver

• Breath in → hold → breath out
• Holding will make the sound louder and more clear

DDx

• indicate pulmonary hypertension
  • Palpable, loud P2
• ASD
• AVSD

If you hear P2 in non-pulmonic region, it is a loud P2 (ASD, PH)

https://youtu.be/98HM1fr3cq4?t=90