The atrial sound in ischaemic heart disease.

A study was made of the diagnostic value of the atrial sound in ischaemic heart disease. It is shown that in ischaemic heart disease, whether or not infarction has occurred, an atrial sound is usually present and can be detected both clinically and phonocardiographically. Its absence makes the presence of ischaemic heart disease unlikely. In a clinical series of 276 consecutive cases of myocardial infarction an atrial sound was heard early in the illness in 98 per cent if the few with dysrhythmias, mitral stenosis, and inaudible heart sounds from impending death are excluded. In a clinical and phonocardiographic study of 130 consecutive patients admitted to a coronary care unit, highly significant statistical significance is shown for the presence or absence of an atrial sound at the beginning of the illness in diagnosing the presence or absence of myocardial infarction. In So consecutive patients with angina and no evidence of infarction all had an atrial sound heard and recorded phonocardiographically. Electrocardiographic evidence of left atrial hypertrophy is common and occurred in 40 per cent of the patients studied. Atrial sounds occur in symptom-free middle-aged and older people and may indicate presymptomatic ischaemic heart disease. This group might repay further study. The vibrations of atrial

[1]  Aubrey Leatham,et al.  Auscultation of the Heart and Phonocardiography , 1971, Journal of the Royal College of Physicians of London.

[2]  K. Luomanmäki,et al.  Value of serial P wave changes in indicating left heart failure in myocardial infarction , 1970, British heart journal.

[3]  W. P. Harvey.  Some Pertinent Physical Findings in the Clinical Evaluation of Acute Myocardial Infarction , 1969 .

[4]  R. Gramiak,et al.  Determinants of atrial (S4) and ventricular (S3) gallop sounds in primary myocardial disease. , 1968, The New England journal of medicine.

[5]  L. Mcdonald,et al.  Delayed closure of the aortic valve in ischaemic heart disease. , 1967, British heart journal.

[6]  E. Stock.  AUSCULTATION AND PHONOCARDIOGRAPHY IN ACUTE MYOCARDIAL INFARCTION , 1966, The Medical journal of Australia.

[7]  P. Shah,et al.  Controversial and changing aspects of auscultation: III. Diastolic sounds IV. Intervals V. Systolic sounds , 1963 .

[8]  P. Kincaid‐smith,et al.  THE ATRIAL SOUND AND THE ATRIAL COMPONENT OF THE FIRST HEART SOUND , 1959, British heart journal.

[9]  P. Kincaid‐smith,et al.  THE ATRIAL SOUND IN HYPERTENSION AND ISCHÆMIC HEART DISEASE WITH REFERENCE TO ITS TIMING AND MODE OF PRODUCTION , 1959, British heart journal.

[10]  A. Weissler,et al.  Observations on the Mechanism of Atrial Gallop Rhythm , 1958, Circulation.

[11]  W. Evans.  Hypertonia or uneventful high blood pressure. , 1957, Lancet.

[12]  W. Blakemore,et al.  Diastolic gallop sounds, the mechanism of production. , 1957, The Journal of clinical investigation.

[13]  D. Weitzman.  THE MECHANISM AND SIGNIFICANCE OF THE AURICULAR SOUND , 1955, British heart journal.

[14]  B. Miles,et al.  THE CLINICAL SIGNIFICANCE OF GALLOP RHYTHM IN HYPERTENSION , 1951, British heart journal.

[15]  W. Evans.  THE USE OF THE PHONOCARDIOGRAPH IN CLINICAL CARDIOLOGY , 1948, British heart journal.

[16]  A. Selzer,et al.  A NEW SIGN OF LEFT VENTRICULAR FAILURE , 1939, British heart journal.

[17]  P. Duchosal.  A study of gallop rhythm by a combination of phonocardiographic and electrocardiographic methods , 1932 .

[18]  R. O'Rourke.  Gallop rhythm. , 1972, The Medical annals of the District of Columbia.

[19]  C. H. Lockwood.  Diuretic therapy. , 1961, Medical services journal, Canada.

[20]  P D White,et al.  The Clinical Significance of Gallop Rhythm. , 1927, Transactions of the American Climatological and Clinical Association. American Climatological and Clinical Association.