Document Detail


Re-evaluation of normal splitting of the second heart sound in patients with classical left bundle branch block.
MedLine Citation:
PMID:  7960260     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To study the mechanism of normal splitting of the second heart sound in patients with classical left bundle branch block, we investigated 43 such patients and 15 normal controls, using electro-, phono- and echo-cardiography and comparing the relative timing of mechanical activity in the two ventricles. The splitting of the second heart sound is reversed in only two-thirds of the patients and normal in remaining one-third. Comparing patients with and without reversed splitting, there are no significant differences in left ventricular cavity size, heart rate, pre-ejection period and the distribution of age, gender, or aetiology. QRS duration is longer (P < 0.01) in patients with reversed splitting. Diastolic events of the left ventricle do not differ between groups. The onset of the left ventricular free wall motion is delayed compared with normal by a similar extent in the two groups. In patients with normal splitting, the onset of the right ventricular wall motion is also delayed, both with respect to normal and to those with reversed splitting to an extent similar to that seen in classical right bundle branch block. Normal splitting of the second heart sound associated with an electrocardiographic pattern of left bundle branch block therefore suggests bilateral block. This combination can be documented from the precise timing of the movement of the two ventricles by M-mode echocardiography and identified by simple auscultation.
Authors:
H B Xiao; A H Faiek; D G Gibson
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International journal of cardiology     Volume:  45     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  1994 Jul 
Date Detail:
Created Date:  1994-12-12     Completed Date:  1994-12-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  163-9     Citation Subset:  IM    
Affiliation:
Cardiac Department, Royal Brompton National Heart and Lung Hospital, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Bundle-Branch Block / diagnosis,  physiopathology*
Echocardiography
Electrocardiography
Female
Heart Sounds*
Humans
Male
Middle Aged
Phonocardiography

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


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