On Cardiovascular Sound

McKusick, Victor A.; Webb, George N.; Humphries, J.O'Neal; Reid, J. A.

doi:10.1161/01.cir.11.6.849

Cited by 46 publications

(5 citation statements)

References 4 publications

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“…The brevity of the mitral diastolic murmur in incompetence contrasted with its length in stenosis has been described by Wobd (1956). McKusick (1958) observed that the passive murmur of mitral stenosis may not fill diastole if the disease is trivial and if heart rate or cardiac output is low. Brandenburg and Burchell (1958) rarely found the passive murmur confined to early diastole in cases of advanced mitral obstruction.…”

Section: Discussionmentioning

confidence: 99%

Clinical Assessment of Mitral Orifice in Patients with Regurgitation

Nixon¹,

Wooler²

1960

BMJ

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Section: Discussionmentioning

confidence: 99%

Clinical Assessment of Mitral Orifice in Patients with Regurgitation

Nixon¹,

Wooler²

1960

BMJ

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“…It is now well recognized that with inereasingly severe stenosis the murmur becomes more prolonged and the splitting wider.' [12][13][14] Conversely production of mild stenosis by a valvotomy promptly shortens the murmur and reduces the width of splitting.4 ( fig. 4).…”

Section: Methodsmentioning

confidence: 99%

Auscultatory and Phonocardiographic Assessment of Pulmonary Stenosis with Intact Ventricular Septum

Vogelpoel

Schrire

1960

Circulation

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THE COMPLETE diagniosis in a case of pulmonary stenosis must include correct assessment of the anatomic situation as well as its severity. In 2 previous studies1' 2 concerning the differentiation of severe pulmonary stenosis with intact ventricular septum from Fallot's tetralogy a striking difference was found in the duration of the systolic murmur that enabled the anatomic diagnosis to be settled by bedside auscultation. It was also shown that the severity of the stenosis influences the duration of the murmur in opposite fashion in the 2 conditions. Increasingly severe stenosis lengthened the murmur when the ventricular septum was intact but shortened it when a large septal defect was present (Fallot's tetralogy). The different behavior of the murmur was dependent on the different dynamic situation in the 2 conditions. The purpose of this paper is to draw attention to the value of auscultation and phonocardiography in diagnosing the severity of stenosis when the ventricular septum is intact. Their value in Fallot's tetralogy is described in a separate paper.3 Reliable criteria based on the murmur length and width of splitting of the second sound will be defined, enabling accurate prediction of the severity of the stenosis. These are of considerable value in assessing the result of surgery. Full clinical examination with special attention to auscultation was carried out independently by us, after which data were compared and finally checked with the phonocardiogram. Particular attention was paid to the intensity and duration of the systolic murmur at the site of its maximal intensity. The intensity was graded from 1 to 6 and the duration was analyzed by noting whether the crescendo was in early, mid, or late systole, whether the murmur ended before, at, or extended beyond the aortic component of the second sound, and whether this sound was clear, partially buried, or obscured by the murmur. Splitting of the second 55 by guest on May 12, 2018 http://circ.ahajournals.org/ Downloaded from

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“…The concept of analysing heart sounds using spectral analysis was first proposed in 1955 [ 7 ]. Previous research has demonstrated that coronary stenosis leads to the production of high-frequency sounds caused by turbulent blood flow in partially blocked arteries [ 8 ].…”

Section: Introductionmentioning

confidence: 99%