Disease relevance of Heart Sounds

• These data suggest that long-term digoxin therapy is clinically beneficial in patients with heart failure unaccompanied by atrial fibrillation whose failure persists despite diuretic treatment and who have a third heart sound [1].
• Preoperative echophonocardiographic study of a 31 year old woman with Ebstein's anomaly and an atrial septal defect showed wide splitting of the first heart sound with an interval of 0.08 second between mitral valve and tricuspid valve closure [2].
• Lack of efficacy of digoxin in treatment of compensated congestive heart failure with third heart sound and sinus rhythm in elderly patients receiving diuretic therapy [3].
• The dynamics of the delayed accentuated mitral component (M1) of the first heart sound and the MOS were studied in 11 patients with mitral stenosis of varying severity [4].
• We have observed patients in whom the third heart sound (S3) gallop, the diastolic flow murmur of atrial septal defect and mitral insufficiency and the initial muscular component of the first heart sound become more intense during this period with short, critically timed cycle lengths [5].

High impact information on Heart Sounds

• Patients who responded to digoxin had more chronic and more severe heart failure, greater left ventricular dilation and ejection-fraction depression, and a third heart sound [1].
• The mechanism of splitting of the second heart sound in atrial septal defect [6].
• Computer analysis of the recordings was used to measure the left ventricular end-diastolic diameter, the click diameter (left ventricular diameter at the time of mid-systolic click), the maximal velocity of circumferential fiber shortening (max VCF), and the time interval between the first heart sound and systolic click (S1-X) [7].
• Of the clinical variables, elevated jugular venous pressure and third heart sound (S3) gallop were significantly associated with increased levels of plasma norepinephrine, plasma renin activity and atrial natriuretic peptide [8].
• The mechanism for the reactions in these patients is not known, but the absence of heart sounds in the presence of no palpable pulse and no obtainable blood pressure should now be included among the adverse effects that may occur after administration of protirelin IV [9].

Biological context of Heart Sounds

• Ethanol increased the heart rate but did not change the peak transmitral velocities, the normalised peak filling rate, the deceleration of early flow, or the duration of relaxation as measured from the second heart sound to the peak early diastolic velocity [10].
• The clinical triad of raised central venous pressure, muffled heart sounds, and low blood pressure levels was present in 33 per cent of the patients with cardiac tamponade [11].

Anatomical context of Heart Sounds

• A case of secundum atrial septal defect combined with aortic stenosis and coronary artery disease showing a single second heart sound [12].

Associations of Heart Sounds with chemical compounds

• The effect of halothane on the amplitude and frequency characteristics of heart sounds in children [13].
• The cardiovascular responses to isometric and dynamic exercise have been studied in six normal subjects, before and after intravenous propranolol, using the amplitude of the first heart sound (S1), measured from an ultra-low frequency phonocardiogram, as an index of left ventricular mechanical performance [14].
• METHODS: A total of 106 physicians in the Family Medicine Training Programme were asked to identify 10 cardiac sounds played sequentially on the Littmann electronic stethoscope, which functioned as a surrogate patient [15].
• The system displays ECG, Temperature and CO2 as well as the envelope of heart sounds in real time [16].

Gene context of Heart Sounds

• Normal and abnormal heart sounds in cardiac diagnosis. Part I: Systolic sounds [17].
• In order to detect such sounds, recordings of diastolic heart sound segments were analyzed by using four signal processing techniques; the Fast Fourier Transform (FFT), the Autoregressive (AR), the Autoregressive Moving Average (ARMA), and the Minimum-Norm (Eigen-vector) methods [18].
• Third; classification of the heart sound using an Artificial Neural Network. Initial testing revealed the intelligent diagnostic system can differentiate between normal healthy heart sounds and abnormal heart sounds (e.g., murmurs), with a specificity of 70.5% and a sensitivity of 64.7% [19].
• The genesis of the third heart sound in ischemic cardiomyopathy [20].
• All 12 infants had atypical findings including a holosystolic murmur parasternally and absence of wide fixed splitting of the second heart sound, and none were clinically suspected to have an ASD [21].

Analytical, diagnostic and therapeutic context of Heart Sounds

• Left ventricular hypertrophy was evident by physical examination as in other forms of hypertrophic cardiomyopathy, but a systolic murmur was faint or absent and the second heart sound was frequently split [22].

References