Pulsations of the Wall of the Chest

Dressler, W

doi:10.1001/archinte.1937.00180020049004

Cited by 24 publications

(5 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus Mackenzie (1902) thought that right ventricular systole always produced depression of the chest wall. Dressler (1937) was the first to suggest the importance of recording absolute movement and arranged his instrument in a fixed support attached to the bed. He showed that in normal subjects there might be systolic depression at the left sternal edge, but in patients with right ventricular hypertrophy resulting from severe mitral stenosis there was a marked systolic outward movement.…”

Section: Discussionmentioning

confidence: 99%

The Left Parasternal Impulse

Gillam¹,

Deliyannis²,

Mounsey³

1964

Heart

View full text Add to dashboard Cite

A lift or heave which is palpable at the left sternal edge is an accepted clinical sign of right ventricular hypertrophy. The parasternal impulse has been recorded in normal subjects and in patients with heart disease, and the results are described in this paper. A detailed description of the instrument used to make the recordings has already been published (Beilin and Mounsey, 1962). This instrument records absolute displacement of a selected area on the chest wall. By correlating the recordings with clinical examination, chest radiographs, electrocardiograms, and the results of right heart catheterization, we have been able to define, in terms of displacement, the characteristics that distinguish normal from abnormal impulses. We have also attempted to assess the reliability of an abnormal impulse in revealing underlying ventricular and atrial hypertrophy. SUBJECTS AND METHODSThe impulse cardiogram was recorded with the patient lying on a couch in the semi-recumbent position, with the breath held in expiration. The recording instrument consists essentially of a brass rod with a small button 3 mm. in diameter at one end, which is placed on the chest wall and moved up and down by the cardiac impulse. Movement of the rod interrupts a beam of light on a photoelectric cell: this varies the resistance in an electrical circuit, the current from which is fed into the extra low frequency galvanometer of a Cambridge phonocardiograph. The recording system was arranged so that 1 mm. of movement of the chest wall produced a 5 cm. deflection in the impulse cardiogram. A simultaneous electrocardiogram and phonocardiogram were recorded as reference tracings.The left parasternal impulse was recorded at the site of greatest pulsation. In some patients this was in the third or fourth intercostal space; in others the fourth, fifth, and sixth costal cartilages were so close together that the knob of the recorder was placed on top of them. The exact site of the left parasternal impulse was recorded in each case. The apical impulse was also recorded routinely in all cases.Twenty normal subjects and 71 patients with heart disease were studied. Of the 20 normal subjects, 6 were volunteers from among the medical staff, and 14 were patients with clinically normal hearts. There were 14 males and 6 females, 3 of whom were children; their ages varied from 5 to 52 years. Of the 71 patients, 9 had pulmonary stenosis, 4 had Fallot's tetralogy, 8 had atrial septal defect, 15 had ventricular septal defect, and 1 had a patent ductus arteriosus; 8 patients had mitral stenosis and 14 mitral incompetence; 1 had primary pulmonary hypertension, and 1 pulmonary hypertension resulting from chronic bronchitis and emphysema; 10 patients were suffering from cardiomyopathy. There were 28 males and 43 females, 12 of whom were children; their ages varied from 5 to 70 years. In all patients a full 14-lead electrocardiogram, and posteroanterior and lateral chest radiographs were used for the assessment of right ventricular hypertrophy. The electrocardiographic...

show abstract

Section: Discussionmentioning

confidence: 99%

The Left Parasternal Impulse

Gillam¹,

Deliyannis²,

Mounsey³

1964

Heart

View full text Add to dashboard Cite

show abstract

“…The current passed through the photoelectric cell is fed into a low frequency galvanometer and thus an optical record is obtained. The impulse recorder measures displacement of the site on the chest wall examined in relation to a fixed point in space (Dressler, 1937;Eddleman et al, 1953;Mounsey, 1957). It does not measure relative displacement of a site in an intercostal space in relation to the surrounding chest wall, as in the conventional apex cardiogram (Marey, 1878;Mackenzie, 1902;Volhard, 1904;Weitz, 1917;Johnston and Overy, 1951;Luisada and Magri, 1952;Benchimol, Dimond, and Carson, 1961).…”

Section: The Investigationmentioning

confidence: 99%

The Cardiac Impulse and the Motion of the Heart

Deliyannis¹,

Gillam²,

Mounsey³

et al. 1964

Heart

View full text Add to dashboard Cite

"Quod erigitur cor, et in mucronem se sursem elevat, sic ut illo tempore ferire pectus, et foris sentiri pulsatio possit." "The heart erects, and raises itself into a point, so that at this moment it strikes the chest wall, and externally a pulsation can be felt."William Harvey, Exercitatio anatomica de Motu Cordis et Sanguinis in Animalibus. Frankfurt, 1628. The apex beat and the character of the apical impulse are today universally accepted as basic and important physical signs: yet their mode of production remains only partially understood. Uncertainty exists as to which ventricle forms the apical impulse in health, Haycraft (1891) and Rushmer (1961) suggesting that it is formed by the right rather than the left ventricle, as is more usually held. The position of the apex beat is emphasized as of importance in the clinical assessment of heart size, yet the inconstant association between this point and the anatomical apex of the heart is less well known (Roesler, 1937). Finally, although the heaving sensation imparted to the hand by the hypertrophied left ventricle is familiar to all, the exact mechanism by which contraction of the hypertrophied heart produces this sensation is incompletely understood.In this paper we have attempted to answer some of these questions. We have studied the genesis of the apical impulse in health and left ventricular hypertrophy, by recording the form of the impulse and relating this to the movements of the left ventricular cavity in timed left ventricular angiocardiograms. In addition, using the dissection technique of Mall (1911) modified by Lev and Simkins (1956) to separate the heart muscle into different functional layers, we have shown how disturbance of the normal balance of forces of constriction and retraction within the separate myocardial functional layers may be responsible for the abnormal form of ventricular contraction in left ventricular hypertrophy. THE INVESTIGATIONThe apical impulse was recorded by the method described by Beilin and Mounsey (1962). The recording instrument, which is fixed to a rigid stand, contains a light metal rod, supported on light springs, which is applied to the chest wall in the axis of the movement to be recorded (Fig. 1). Displacement of the rod in its long axis varies the area of the photoelectric cell exposed to the light source. The current passed through the photoelectric cell is fed into a low frequency galvanometer and thus an optical record is obtained. The impulse recorder measures displacement of the site on the chest wall examined in relation to a fixed point in space (Dressler, 1937;Eddleman et al., 1953;Mounsey, 1957). It does not measure relative displacement of a site in an intercostal space in relation to the surrounding chest wall, as in the conventional apex cardiogram

show abstract

“…During isovolumetric contraction, the heart normally undergoes a partial rotation in a counterclockwise direction, causing the lower front part of the left ventricle to strike the front of the chest wall [1]. Also, the left ventricle shortens while contracting, shaping the heart to be more spherical, increasing its diameter, and further adding to the impulse on the chest wall [2]. The peak outward motion of the left ventricular impulse occurs either simultaneously with or just after the opening of the aortic valve.…”

Section: Surface Motion Due To the Cardiac Cyclementioning

confidence: 99%

Position-Free Vital Sign Monitoring: Measurements and Processing

Obeid¹,

Samad²,

Sadek³

et al. 2016

Advanced Biosignal Processing and Diagnostic Methods

View full text Add to dashboard Cite

International audienceAs traditional electrodes are perturbing for patients in critical cases such as for burn victims or newborn infants, and even to detect life sign under rubble, a contactless monitoring system for the life signs is a necessity. The aim of this chapter is to present a complete process used in detecting cardiopulmonary activities. This includes a microwave Doppler radar system that detects the body wall motion and signal processing techniques in order to extract the heartbeat rate. Measurements are performed at different positions simultaneously with a PC-based electrocardiogram (ECG). For a distance of 1 m between the subject and the antennas, measurements are performed for breathing subject at four positions: front, back, left, and right. Discrete wavelet transform is used to extract the heartbeat signal from the cardiopulmonary signal. The proposed system and signal processing techniques show high accuracy in detecting the cardiopulmonary signals and extracting the heartbeat rate

show abstract

Pulsations of the Wall of the Chest

Cited by 24 publications

References 3 publications

The Left Parasternal Impulse

The Left Parasternal Impulse

The Cardiac Impulse and the Motion of the Heart

Position-Free Vital Sign Monitoring: Measurements and Processing

Contact Info

Product

Resources

About