Auscultatory and Phonocardiographic Signs of Atrial Septal Defect

Clinical Recognition of Tricuspid Stenosis

“…The precedence in the cardiac cycle of tricuspid over mitral opening snap (first and fourth criteria) is at variance with statements of others10 and is based on the following observations. In the dog, isometric right ventricular diastole (the interval betweeni closure of the pulmonary valve and opening of the tricuspid) is significantly shorter thani isometric left ventricular diastole (the interval between closure of the aortic valve and opening of the mitral).19 The sequence of events of the cardiac cycle in the dog and in man is generally similar.20 Finally, the opening sound of the tricuspid valve that is believed to occur occasionally in atrial septal defeet 21,22 has an early timing consistent with the foregoing colitentions.…”

Peripheral pulmonary artery murmur of atrial septal defect

“…Origin ofthe murmur at the pulmonary orifice and not at the septal defect was shown experimentally by Rushmer (1961) and confirmed with intracardiac phonocardiography by Soulie et al (Leatham and Gray, 1956). In generated by rapid flow through non-stenosed the majority of published descriptions little or no arteries is not new and has an analogy, for example, comment has been made on the location of murmur in the collateral vessel bruits of coarctation of the at sites removed from the neighbourhood of the aorta (Spencer et al, 1958).…”

“…(1) AlOn the other hand, Leatham and Gray (1956) though wide radiation is a recognized feature of a described radiation to the apex, and McKusick variety of loud cardiac bruits, the pniecordial mur-(1958) reported transmission to the interscapular murs in our cases were of relatively low amplitude area of the back. Until now, however, considera-(grade 2 to 3 of 6) and hence of intensities insufficition has not been given to the notion that in patients ent to offer an acceptable explanation for such wide with atrial septal defect systolic murmurs may occur distribution on the basis of transmission alone at non-praecordial sites because of the origin of ( Fig.…”

Intracardiac Phonocardiogram in Thirty Cases of Atrial Septal Defect

“…This substantiates the hypothesis of Barber et al1 and Leatham and Gray. 5 There is great diversity of opinion regarding the source and mechanism of the apical mid-diastolic and the presystolic murmnurs in atrial septal defect. The possibilities suggested are all associated mitral stenosis,16-18 flow across the septal defect, 1' 19, 20 and increased flow through the tricuspid valve.'…”

“…[1][2][3][4][5][6][7] The commonest auscultatory findings in uncomplicated atrial septal defect are a basal systolic ejection murmur, usually soft, and a wide, fixed splitting of the second sound over the pulmonary area. Less frequently an early blowing diastolic murmur is heard at the base and along the left sternal border iii the second and third left intercostal spaces.…”