The pulmonary component of the second heart sound in acquired aortic stenosis

The amplitude of the pulmonic component of the second sound in aortic stenosis was studied in 49 patients with this lesion. As controls, 50 normal subjects were also studied. Both groups were investigated by phonocardiography, apex cardiography and arterial tracings. Nineteen patients with aortic stenosis and four subjects without it were also studied by cardiac catheterization and angiography. The amplitudes of the two components of the second sound were compared, and the ratio of each with the amplitude of the first sound was determined. The ratios of both the aortic and the pulmonic component to that of the first sound were decreased in aortic stenosis, and the decrease of the pulmonic component was comparable to that of the aortic component. These findings could be related to prolongation of the isovolumic relaxation period of both ventricles caused by an influence of the left ventricle on the right, most likely due to functional changes of the interventricular septum.