The Heart-Sounds in Normal and Pathological Conditions

The Duration of Normal Heart Sounds

“…Both the first and the second sounds are caused by four different factors. Four different components were, therefore, described in both the first (Orias and Braun Menendez, 1939) and second sounds. (Rappaport andSprague, 1941 and1942) The systematic clinical use of phonocardiography convinced one of us (Luisada) of the extreme variability of the complexes of the heart sounds even in normal subjects.…”

“…As will be noted, our division into components of the first sound is slightly different from that of Orias and Braun Menendez (1939) for the following reasons.…”

Phonocardiography

“…The apparatus is difficult to use, and as successive membranes differ in thickness the sensitivity to low-frequency vibrations is variable. Despite these difficulties an excellent monograph on the heart sounds and murmurs was published by Orias and Braun-Menendez (1939).…”

Phonocardiograms of Auricular Murmurs From a Case With Mitral Stenosis and Heart Block

“…In some instances it can be shown that the so-called first heart sound consists of a fusion of an auricular sound with a ventricular sound, and this may be evident in cases with prolongation of the P-R interval. This, however, is generally not easily recognized; otherwise there should be a presystolic sound or a double first heart sound in all cases of partial A-V block.In their monograph, Orias and Braun-Menendez (1939) state that three different acoustic phenomena contribute to the auricular first heart sound, namely-and in the following ordervibrations in the contracting auricles, the dilatation of the ventricles during their filling with blood, and vibrations in the mitral and tricuspid valves at the closure of the corresponding orifices at the end of the auricular systole. The first mentioned can only be studied from the cesophagus; the other two from the precordium also.…”

“…It is stressed by different authors (Orias and Braun-Menendez, 1939;Bramwell, 1935;and Cossio and Fongi, 1936) that the auricular first heart sound will be increased during conditions, when the blood stream through the auriculo-ventricular orifices is increased or hastened (thyrotoxicosis, hypertension, and mitral stenosis with left auricular hypertrophy). It is also easy to understand that the rigidity of the valves in mitral stenosis might change the auricular sound to a murmur.…”