It is commonly accepted as a fact that the absolute and relative intensities of the two heart sounds not only offer valuable information concerning the dynamic state of the heart muscle, but also serve as a criterion of the pressure conditions in the greater and lesser circuits. This conception, based on plausible physical assumptions and fortified by clinical experience, has, however, received only cursory attention from experimental investigators. Lewis,1 in his experimental studies of the recorded heart sounds, tested the effect of raising the arterial pressure by aortic compression, but was unable to corroborate one general idea, viz., that high arterial pressure, per se, is responsible for an accentuation of the aortic second sound. On the other hand, the experiments of Dean and myself2 indicated that the intensity of the sounds directly recorded from the heart is determined by the dynamic conditions of the circulation. Thus, we found
WIGGERS CJ. FACTORS DETERMINING THE RELATIVE INTENSITY OF THE HEART SOUNDS IN DIFFERENT AUSCULTATION AREAS: AN EXPERIMENTAL STUDY. Arch Intern Med (Chic). 1919;24(5):471–488. doi:10.1001/archinte.1919.00090280002001
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