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January 15, 1973

The Sounds of the Normal Heart

JAMA. 1973;223(3):332-335. doi:10.1001/jama.1973.03220030066040

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


From Laennec (1781-1826) to Luisada, great strides have been made in our knowledge of cardiovascular physiology and the origin of intravascular sounds and murmurs. Dr. Luisada and his associates have played a major role over the last 30 years in expanding the scope and instrumentation of clinical phonocardiography and in compelling cardiologists and cardiovascular physiologists to reevaluate concepts of older clinicians.

Some concepts summarized in this book based on Dr. Luisada's work remain controversial, but time may indeed prove their value. For example, Luisada's school suggests that the locations and designations of the areas of cardiac auscultation should be reevaluated and restated in terms of physiologic principles. As he points out, the location of the four auscultatory areas, empirically selected because of correlation between the murmur and the finding of a diseased valve at necropsy, had already been accepted in 1884 and had been challenged only recently.

Furthermore, the demonstration