The Apex Cardiogram: Its Normal Features Explained by Those Found in Heart Disease

Coulshed, N; Epstein, Eric J.

doi:10.1136/hrt.25.6.697

Cited by 59 publications

(19 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[5,6] The ACG is a promising complementary analysis to ECG. [7,8] We fabricated a stretchable e-skin ACG strain sensor from a composite of metal nanoparticles and an elastomer. The 2D percolation of metal particles provides high sensitivity to small strains (ε < 2%) during apex palpitation and also high stretchability (ε > 30%) for large body motions.…”

mentioning

confidence: 99%

Stretchable E‐Skin Apexcardiogram Sensor

et al. 2016

View full text Add to dashboard Cite

show abstract

mentioning

confidence: 99%

Stretchable E‐Skin Apexcardiogram Sensor

et al. 2016

View full text Add to dashboard Cite

show abstract

“…The low frequency vibrations, which result from relative movement in the chest wall beneath the cup applicator, are thought to result from actual movement of the heart and great vessels, from changes in volume and velocity of movement of the heart, and from changes in the consistency and curvature of the heart wall. 4 and chamber geometry might be expected to induce changes in the systolic configuration of the apexcardiogram. Vakil6 described three types of abnormal pulsations in patients with acute myocardial infarction.…”

mentioning

confidence: 99%

The Apexcardiogram in Myocardial Asynergy

et al. 1968

View full text Add to dashboard Cite

SUMMARYThe apexcardiogram was analyzed in 41 patients with an altered pattern of left ventricular contraction. Four types were distinguished: type I, an early sustained systolic bulge which occurred in 12 patients, all of whom had large aneurysms and large enddiastolic volumes; type II, a bulge confined to midsystole which occurred in 13 patients, 11 of whom had some form of ventricular asynergy; type III, a late or end-systolic bulge which occurred in 12 patients, seven of whom had ventricular asynergy; type IV, a prominent spike during diastolic filling which occurred in four patients who had large zones of ventricular asynergy. Additional Indexing Words:Aneurysm Abnormal myocardial contraction THE NORMAL apexcardiogram and its temporal relationship to electrical, acoustical, and mechanical cardiac events has been the subject of previous communications from various laboratories,1 2 including our own.3 The normal pattern is uniform, reproducible, and clearly correlated with known hemodynamic events.Lack of general agreement about the genesis of the apexcardiogram and technical difficulties in recording it have discouraged a more general use. The low frequency vibrations, which result from relative movement in the chest wall beneath the cup applicator, are thought to result from actual movement of the heart and great vessels, from changes in volume and velocity of movement of the heart, and from changes in the consistency and curvature of the heart wall.4' 5 Particular difficulty arises in attempting to evaluate systolic events from the apexcardiogram.

show abstract

“…In our own records, the A wave of the apex cardiogram coincided with the fourth heart sound or with the atrial component of the first heart sound in the phonocardiogram (as in the study of Benchimol and Dimond, 1963a). Coulshed and Epstein (1963) believe that the A wave of the apex cardiogram imifiediately precedes the fourth sound, but Orias and Braun-Menendez (1939) are of the opinion that the A wave follows the fourth heart sound. Benchimol and Dimond (1963a) and Tabatznik (1964) stated that the A wave occurred 0-08 to 0-12 second after onset of the P wave of the electrocardiogram and coincided with, or shortly preceded, the QRS wave in the electrocardiogram.…”

Section: Discussionmentioning

confidence: 99%

The A wave of the apex cardiogram in idiopathic hypertrophic subaortic stenosis.

Wolfe¹

1966

Heart

View full text Add to dashboard Cite

Idiopathic hypertrophic subaortic stenosis was first clearly described as a clinical entity by Brock (Benchimol and Dimond, 1963a), the kinetocardiogram (Eddleman et al., 1953), and the method of Beilin and Mounsey (1962). Reviews of recent studies of apex cardiograms have been made (Rorvik, 1963;Benchimol and Dimond, 1963a).It is the purpose of this paper to describe the changes in the apex cardiogram in muscular subaortic stenosis, and of particular interest has been the increase in size of the A wave. SUBJECTS AND METHODSThe apex cardiogram was obtained according to the procedure ofHartman and Snellen (1960), and Benchimol and Dimond (1963a). The apex cardiogram indicates displacement over the apex of the heart; the frequencies are in the range of 01 to 50 cycles per second and are below the frequency audible by means of the stethoscope. The records were taken with the patient lying Received March 12, 1965. in the left lateral position with the pick-up bell placed over the point of maximum impulse of the heart, as felt with the palm of the hand. The microphone was usually held by the person taking the record. The patient was told to hold his breath temporarily in midexpiration. Most of the records were obtained at a paper speed of 75 mm./second; occasionally 100 mm./ second was used.The A wave occurs just before the QRS wave of the electrocardiogram and about 0 10 second after the beginning of the P wave. It is measured from the end of the slow filling wave and the width normally measures 0X02 to 0 05 second. The A wave ratio is the percentage height of the A wave in relation to the total height of the record, measured vertically from the E point to the O point. The AE interval is measured from the peak of the A wave to the E point, and varies from 0 03 to 0 28 second, in normal subjects. The isometric contraction time is measured from the end of the A wave to the E point, and its normal duration is 0 03 to 0-06 second. The rapid filling wave ratio is the percentage height of the rapid filling wave to the total amplitude, measured vertically from the E point to the 0 point. It is normally 20 to 40 per cent, with a duration of 0 04 to 0-08 second. The E point is the point of aortic valve opening. The 0 point is the point of mitral valve opening.The apex cardiograms of 9 patients in whom the diagnosis of muscular subaortic stenosis had been proved by means of catheterization were studied. RESULTSThe records obtained in our 9 patients are reproduced in the Figure. The data in these patients are presented in the Table. It is seen that the A wave amplitude ratio in the apex cardiogram (ACG) was increased to an unusual degree in 8 of the 9 (average 28-1%). The A wave was abnormally wide in 7 of the 8 patients in whom it could be measured. A late systolic bulge was seen in 2 of 179 on 12 May 2018 by guest. Protected by copyright.

show abstract

The Apex Cardiogram: Its Normal Features Explained by Those Found in Heart Disease

Cited by 59 publications

References 31 publications

Stretchable E‐Skin Apexcardiogram Sensor

Stretchable E‐Skin Apexcardiogram Sensor

The Apexcardiogram in Myocardial Asynergy

The A wave of the apex cardiogram in idiopathic hypertrophic subaortic stenosis.

Contact Info

Product

Resources

About