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[A fourth tone and latent cardiac insufficiency in ischemic heart disease]
Insights
The fourth heart sound can help diagnose latent cardiac insufficiency. Its persistence in infarct patients suggests latent heart failure may not exist, warranting further study.
Area of Science:
- Cardiology
- Cardiac Diagnostics
- Non-invasive Assessment
Context:
- Assessing the fourth heart sound (S4) as a diagnostic tool.
- Investigating S4 in healthy subjects and myocardial infarction (MI) patients.
- Evaluating S4 under basal, post-exercise, and post-digitalis conditions.
Purpose:
- To evaluate the fourth heart sound as a non-invasive aid for diagnosing latent cardiac insufficiency.
- To determine the diagnostic value of S4 persistence in various positions and after interventions.
Summary:
- The fourth heart sound was recorded in healthy individuals and MI patients in different positions and conditions.
- S4 persisted in the standing position in nearly all MI patients.
- Digitalis administration significantly decreased the incidence of S4.
Impact:
- Findings suggest latent heart failure may not exist as previously thought.
- The study proposes further investigation and correlation of S4 with other diagnostic methods.
- Highlights the potential of S4 as a non-invasive diagnostic marker in cardiology.
Abstract:
An assessment was made of the fourth heart sound as a non-invasive clinical and instrumental aid in the diagnosis of latent cardiac insufficiency. The sound was recorded in various decubitus positions in a series of healthy subjects and patients with recent and past infarction, under basal conditions, after exercise on the cycle ergometer, and after digitalis i.v. Persistence of the fourth sound in the standing position was noted in nearly all infarct patients, while its incidence decreased significantly after digitalis. It is felt that this finding can be interpreted as evidence of the non-existence of latent heart failure. Its further investigation and correlation with other invasive and non-invasive instrumental examinations is proposed.