CARDIOVASCULAR SOUNDS RELATED TO EXTRASYSTOLES: I. TWO CASES OF SINUS EXTRASYSTOLES WITH BIGEMINY.
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Biomedical subjects
Publications and source records attributed to H N SEGALL.
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This study forms part of a project to define the range of normal for heart sounds and murmurs. Using the method of writing quantitative symbol phonocardiograms, data were collected on one female and one male subject from earliest infancy to adulthood (aged 27 and 25). Serial measurements of heart size, arterial pressure and records of electrocardiograms and electrophonocardiograms were made. The heart sounds are shorter and somewhat less loud under the age of two years than later. Physiologic splitting of the first and second sounds, a physiologic systolic murmur, the appearance and disappearance of a third sound are shown in the illustrations which epitomize this study. These longitudinal studies of age period changes in the electrocardiogram reveal what has been learned from the horizontal studies. The shape of the cardiac silhouette as recorded between the ages of 5 and 8 years seems to predict the adult shape. The adult type of arterial pressure became established in the early teens.
Cardiovascular sound escaped attention until Laennec invented and demonstrated the usefulness of the stethoscope. Accuracy of diagnosis using cardiovascular sounds as clues increased with improvement in knowledge of the physiology of circulation. Nearly all currently acceptable clinicopathological correlations were established by physicians who used the simplest of stethoscopes or listened with the bare ear. Certain refinements followed the use of modern methods which afford greater precision in timing cardiovascular sounds. These methods contribute to educating the human ear, so that those advantages may be applied which accrue from auscultation, plus the method of writing quantitative symbols to describe what is heard, by focusing the sense of hearing on each segment of the cardiac cycle in turn. By the year 2016, electronic systems of collecting and analyzing data about the cardiovascular system may render the stethoscope obsolete.
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