The graphic registration of the normal heart sounds

Rappaport, Maurice; Sprague, Howard B.

doi:10.1016/s0002-8703(42)90541-6

Cited by 119 publications

(27 citation statements)

References 20 publications

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“…Schiitz (1933), Orias & Braun-Menendez (1939), Rappaport &Sprague (1942) andLuisada (1948) are agreed that atrial systole is normally responsible for the initial vibrations of the first heart sound. If there is delayed conduction of the cardiac impulse from atria to ventricles the vibrations due to atrial systole may become separated from the other elements of the first heart sound and constitute a fourth heart sound; but there was no evidence of delayed atrio-ventricular conduction of the e.c.g.…”

Section: Discussionmentioning

confidence: 99%

Cardiac extra sounds in the dog

Sloan¹,

Wishart²

1953

The Journal of Physiology

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Section: Discussionmentioning

confidence: 99%

Cardiac extra sounds in the dog

Sloan¹,

Wishart²

1953

The Journal of Physiology

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“…Forty-three cases of pulmlonary valvular stenosis and 8 of infundibular stenosis with intact ventricular septum were studied. The diagnoses were confirmed in all by cardiac catheterization and angiocardiography, and in 19 cases at operation, by methods previously described.1' 2 One case came to necxopsy.…”

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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“…Such apparatus was relatively insensitive, but its great disadvantage was the use of acoustic methods of filtration, the variability of which was beyond the control of the woiker. Nevertheless, acoustic methods of filtration, combined with electrical methods are still used by Rappaport and Sprague (1942) and Sprague and Wells (I949), who attach different stethoscope chest pieces to their microphone for murmurs of different frequency.…”

Section: General Considerationsmentioning

confidence: 99%

Phonocardiography

Leatham

1949

Postgraduate Medical Journal

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General ConsiderationsHuman hearing has certain characteristics which must be undeistood before the principles of phonocardiography can be grasped. The audiogram (Fig. i) shows the relative insensitivity of the ear to low tones, and its much greater sensitivity to higher tones. To be heard, a third heart sound, for example, at a frequency of i6 cycles per second, has to be ten thousand million times more intense than a faint murmur at 2,000 cycles. A second property of human hearing is its remarkable sensitivity to frequencies about 2,000 cycles per second, when the-faintest sound which can be heard is one ten-millionth of the intensity of the loudest noise which can be heard without causing pain. This great range of sound intensities which the ear can appreciate, at 2,000 cycles per second, is achieved at the expense of judgment of grades of intensity, for a tenfold increase in intensity of sound may only double its 'loudness' to the ear (Weber-Fechner law) if the sound is of high intensity. At low sound intensities the ear is more sensitive to such changes.The actual intensity of low frequency (low pitched) heart sounds is far greater than that of the higher frequency murmurs, yet to the ear,

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The graphic registration of the normal heart sounds

Cited by 119 publications

References 20 publications

Cardiac extra sounds in the dog

Cardiac extra sounds in the dog

Auscultatory and Phonocardiographic Assessment of Pulmonary Stenosis with Intact Ventricular Septum

Phonocardiography

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