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Article |

The Heart Sounds: New Facts and Their Clinical Implications

Ted Feldman, MD
Arch Intern Med. 1983;143(3):614. doi:10.1001/archinte.1983.00350030228052.
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Better described as a monograph than a book, this is a review of almost 400 past and recent phonocardiographic investigations. The authors advance an understanding of the heart sounds based on their causation by hemodynamic events, rather than by valvular movement or coaptation. For example, in the chapter, "A Unitary Concept of Cardiac Vibrations," the association of the heart sounds with the rate of change of left ventricular pressure is lucidly explained and clearly illustrated. The common notion that intensity of the first heart sound is dependent on mitral leaflet excursion is critically examined and a hemodynamic explanation is proposed.

The first half of the book describes the physical characteristics of sounds, the perception of sounds, and their measurement. The relationship of heart sounds to other events in the cardiac cycle, changes at different ages and in various mammals, and the mechanisms of heart sound production are also discussed in


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