Document Detail

First heart sound and ejection sounds. Echocardiographic and phonocardiographic correlation with valvular events.
MedLine Citation:
PMID:  1114992     Owner:  NLM     Status:  MEDLINE    
To provide additional information on the relation of valvular events to the principal components of the first heart sound (s1), combined echocardiograms and phonocardiograms were recorded in 49 subjects, chosen because of audible splitting of S1 or a combination of S1 and an ejection sound. The subjects included 14 normal persons, 16 patients with a variety of predominantly right-sided heart conditions, 7 with mitral stenosis, 3 with pulmonary stenosis and 9 with aortic valve disease or systemic hypertension. A precise relation was found between completion of closure of the atrioventricular (A-V) valves manifested in the echocardiogram and the high-frequency components of S1 (M1 and T1). The average time from the Q wave of the electrocardiogram to M1 was 0.06 plus or minus 0.003 second and the Q-T1 interval was 0.09 plus or minus 0.002 second. In mitral stenosis the Q-M1 interval was delayed to 0.10 plus or minus 0.005 second, resulting in some instances in reversed splitting of S1. In pulmonary stenosis, the ejection sound occurred 0.10 plus or minus 0.003 second from the Q wave. In 7 of the 16 patients with various right-sided abnormalities, but without valvular stenosis, an ejection sound of pulmonary origin occurred 0.18 plus or minus 0.012 second from the Q wave. In the nine patients with aortic valve disease or systemic hypertension, the time from the Q wave to the aortic ejection sound was 0.13 plus or minus 0.004 second. With only two exceptions the ejection sounds of aortic and plumonary origin coincided exactly with achievement of a fully opened position of the respective semilunar valve. Our findings support the postulate that M1, T1 and the ejection sounds occur in association with closing or opening of valves with consequent sudden deceleration or acceleration of a column of blood that, in turn, results in vibrations of the cardiohemic system and audible sounds.
W Waider; E Craige
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The American journal of cardiology     Volume:  35     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1975 Mar 
Date Detail:
Created Date:  1975-05-10     Completed Date:  1975-05-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  346-56     Citation Subset:  AIM; IM    
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MeSH Terms
Aortic Valve Insufficiency / diagnosis
Aortic Valve Stenosis / diagnosis
Heart Auscultation*
Heart Diseases / diagnosis
Hypertension / diagnosis
Middle Aged
Mitral Valve Stenosis / diagnosis
Pulmonary Valve Stenosis / diagnosis
Time Factors
Tricuspid Valve

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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