Intracardiac phonocardiography

Lewis, David H.; Deitz, George W.; Wallace, James D.; Brown, James Robert

doi:10.1016/s0033-0620(59)80013-x

Cited by 13 publications

(6 citation statements)

References 11 publications

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“…4) and with left ventricular-right atrial communications.14 Lewis et al 4 recorded the murmur of tricuspid regurgitation (TR) in the right atrium in situations where the contour of the right atrial pressure curve did not suggest TR, and also confirmed the inspiratory increase in intensity of the TR murmur within the right atrium which was initially described by Rivero Carvallo63 with external recordings. The sensitivity of ICSP techniques in the detection of TR led to a new appreciation of the frequency of TR in a variety of clinical settings, and to a proposal64 that the classic "functional versus organic" TR classification be discarded and replaced by a categoric approach to the broad spectrum of TR based on disorders of function of the tricuspid valve complex.…”

Section: Murmurs Recorded In the Right Heartmentioning

confidence: 87%

“…The PES accompanying a dilated pulmonary artery with normal pressures was delayed by a variable interval after right ventricular pulmonary artery pressure crossover, and was discussed in terms of distensibility or compliance of the proximal pulmonary artery. Echophonocardiography studies29' 42, 4 showed that PES occurred "at the moment of maximal semilunar valve opening" or "precisely with the achievement of a fully open position by the pulmonic valve," whether associated with pulmonary stenosis or hypertension. Additional integrative studies of the temporal relations of pulmonary valve opening, acceleration of blood flow and behavior of the proximal pulmonary artery may be required before a unifying concept is available.…”

Section: Sounds Associated With Ejection Ejection Sounds In the Aortamentioning

confidence: 99%

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Intracardiac phonocardiography: intracardiac sound and pressure in man.

Wooley¹

1978

Circulation

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Background and Evolution INTRACARDIAC PHONOCARDIOGRAPHY (ICP) isanother step in the development of the scientific basis for auscultation, one of many that date from immediate auscultation and extend through echophonocardiography and nuclear cardiology. The 25 year history of intracardiac phonocardiography, relatively brief in duration, is quite diverse due to the interrelations with other investigative and diagnostic methods that were evolving during the same era. Classic auscultation, external phonocardiography, pressure manometer and recording device development were the evolutionary forerunners of intracardiac phonocardiography, while cardiac catheterization techniques were the vehicle for implementation.ICP, an investigative and diagnostic method, has yielded a body of information which confirmed certain traditional concepts and upset others. Early enthusiastic investigators frequently overemphasized the role of ICP in diagnosis; this misplaced emphasis tended to obscure certain fundamental contributions. In a more conservative vein, Leathaml observed that "intracardiac phonocardiography has mainly served to confirm or consolidate facts which were already known, or have been ascertained in the last 20 years using multichannel external recording apparatus."Yamakawa and associates2 used the term intracardiac phonocardiography in a study in which a condenser microphone was adapted to a catheter, and vascular and cardiac sounds were recorded in 20 dogs and three humans; illustrated tracings from the animal studies were published. There were no published records of the patient studies, and

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Section: Murmurs Recorded In the Right Heartmentioning

confidence: 87%

Section: Sounds Associated With Ejection Ejection Sounds In the Aortamentioning

confidence: 99%

Intracardiac phonocardiography: intracardiac sound and pressure in man.

Wooley¹

1978

Circulation

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“…A somewhat similar murmur is frequently found in intraluminal recordings from the pulmonary artery of patients and is considered a normal finding in man. 9 As the lumen of the pulmonary artery was gradually reduced, the first heart sound became more intense. This increase is undoubtedly related to the greater force of right ventricular contraction which accompanies At the same time, the duration of the murmur increased.…”

Section: Resultsmentioning

confidence: 99%

Study of the Murmur Produced by Acute Pulmonary Artery Constriction

Moedjono

Little

Orlando

et al. 1962

Circulation Research

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• Pulmonary artery constriction has been utilized as an experimental method of stressing the right ventricle 1 " 4 or producing changes in the systemic circulation. "7 As a result, the basic circulatory features of pulmonary artery constriction have been documented. The murmur that is produced by this procedure has not received as much attention. It therefore seemed desirable to investigate this aspect of pulmonary artery constriction. The purpose of this report is to summarize these observations. MethodsDogs were anesthetized with intravenous sodium pentobarbital (30 ing. per Kg.) and the chest opened using a sternal-splitting procedure under mild positive pressure respiration. The right ventricle was cannulated through the azygos vein and the left pulmonary artery via a side branch. A phonocatheter* was also placed in the pulmonary artery by way of a second side branch. This was connected to a Electronics-for-Medicine logarithmic heart sound amplifier. Right ventricular and pulmonary artery pressures were measured electrically using Stathani strain gauges and, together with the intrapulmonary sounds, were recorded photographically using 1 both an Electronics-for-Medicine recorder and a Sanborn twin-beam recorder. Respirations were interrupted during all recordings to avoid artifacts due to lung inflation. The zero level for nil pressure recordings was the level of the right atrium.A ligature was placed around the base of the main pulmonary artery and attached to a screw device similar to that described by Finberg and Wiggers.1 By tightening this instrument, the loop around the pulmonary artery was reduced in size. This instrument was calibrated so that the reduction in the size of the loop was known for each From the Department of Physiology, Seton Hall College of Medicine and Dentistry, Jersey City, New Jersey.Supported in part by a grant from the American Heart Association and from the Burlington County Heart Association.'Manufactured by American Electronic Laboratories, Inc., Philadelphia, Pennsylvania.setting. In addition, immediately following each experiment, the segment of the pulmonary artery containing the stenosis was removed without disturbing the ligature, and the internal diameter was measured for each degree of constriction utilized in that study. As a result, it was possible to quantitate with considerable accuracy the internal cross sectional area of the constriction that was produced in the pulmonary artery by each setting. During a typical experiment the ligature was tightened. Sound and pressure recordings were made and other data obtained. The ligature was then loosened to permit a recovery period before the procedure was repeated at an increased degree of constriction.Cardiac output was determined in some animals during each of the experimental procedures. The dye-dilution technique, as modified by Opdyke and Sniffen, 8 was utilized with tricarbocyanine dye (Cardio-Green*) as the indicator. The dye was injected into the right atrium via a cannula in the right jugular vein, and blood was wi...

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“…Blood flow measurements obtained by the Fick principle showed that while the systeinic flow was within the normal range in all these cases, the pulmonary flow was 2 to 3 times the systemic flow in 8 instances, and over 3 times the systemic flow in the remaining 16. In the 4 cases of Lutembacher's syndrome and persistent atrioventricular canal, the systemic flow was normal, while the pulmonary flow was over 3 times the systemic flow.…”

mentioning

confidence: 81%

“…The technic originally described by Liewis et al 8 Physiologic studies (right heart catheterization, dye-dilution studies, oximetry during exercise2)2-showed that all 24 patients with uncomplicated atrial septal defect had a predominantly left-toright shunt. Blood flow measurements obtained by the Fick principle showed that while the systeinic flow was within the normal range in all these cases, the pulmonary flow was 2 to 3 times the systemic flow in 8 instances, and over 3 times the systemic flow in the remaining 16.…”

mentioning

confidence: 99%

Intracardiac Phonocardiogram in Thirty Cases of Atrial Septal Defect

Feruglio

Sreenivasan

1959

Circulation

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Thirty cases of atrial septal defect proved by cardiac catheterization, surgery, or postmorten examination have been investigated with the technic of intracardiac phonocardiography, which provided precise localization of the source of heart sounds and murmurs. The site and mechanism of origin of the many auscultatory signs in uncomplicated atrial septal defect and in cases of Lutembacher's syndrome, tricuspid atresia, and persistent atrioventricular canal were elucidated by direct intracardiac sound recordings and simultaneous external chest phonocardiograms.THERE have been many recent reports of the auscultatory features of atrial septal defect and these have been reviewed both clinically and with the aid of chest phonocardiography.1-7The 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. At the apex, or medial to it, systolic and diastolic murmurs may occasionally be present, together with an accentuated first sound. The systolic apical murmur is usually of regurgitant type (pansystolic) ; the diastolic apical murmur occurs in mid-diastole or inpresystole.There appears to be no general agreement about the site and mechanism of production of these signs. The relative importance of various factors such as the flow across the atrial septal defect, the increased flow through the tricuspid and pulmonary valves, and the From the

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Intracardiac phonocardiography

Cited by 13 publications

References 11 publications

Intracardiac phonocardiography: intracardiac sound and pressure in man.

Intracardiac phonocardiography: intracardiac sound and pressure in man.

Study of the Murmur Produced by Acute Pulmonary Artery Constriction

Intracardiac Phonocardiogram in Thirty Cases of Atrial Septal Defect

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