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Clinical Cardiology
June 30, 1978

Current Concepts of the Genesis of Heart Sounds: I. First and Second Sounds

Author Affiliations

From the Department of Medicine, Division of Cardiology, University of New Mexico School of Medicine, Albuquerque.

JAMA. 1978;239(26):2787-2789. doi:10.1001/jama.1978.03280530051027

IMPORTANT advances in the understanding of heart sound production have been made in recent years. The work of Aldo A. Luisada, MD, and James A. Shaver, MD, and their respective co-workers has been particularly fertile; Pravin M. Shah, MD, Ernest Craige, MD, and Robert J. Adolph, MD, also have made major contributions. This communication summarizes current concepts of heart sound genesis; areas of unresolved controversy remain, and additional research may further modify our present thinking.

A UNIFIED CONCEPT  Most investigators now agree that all four cardiac sounds result from vibrations of cardiac structures produced by acceleration and deceleration of the blood mass.1 This view, first emphasized by Robert F. Rushmer, MD, stresses that the muscle mass of the left ventricle (LV), the cardiac skeleton, the valves, and the great vessels are all set into vibration by the momentum and velocity of the fluid-filled elastic system during phases of the