[Skip to Content]
[Skip to Content Landing]
March 1968

Acoustic Distinctions in Cardiac Auscultation: With Emphasis on Cardiophonetics, Synecphonesis, the Analysis of Cadence, and the Problems of Hydraulic Distortion

Author Affiliations
West Haven, Conn
From the Department of Medicine, West Haven Veterans Administration Hospital and the Yale University School of Medicine.
Arch Intern Med. 1968;121(3):209-224. doi:10.1001/archinte.1968.03640030001001

Many critical acoustic aspects of cardiac auscultation cannot be adequately portrayed by phonocardiograms. To achieve greater scientific precision in auditory auscultation, clinicians must improve the way they listen to and describe cardiac noises. Acoustic phenomena can be directly communicated by tactile simulation with a stethoscope, or by the vocal use of onomatopoeic syllables. A proper description of the phenomena requires a "dissection" of: acoustic gestalts into the sonority, chronometry, and anatomy of what is heard. Included in the "dissection" is a consideration of the accentuations of cadence, the "masking" produced by synecphonesis, and the effects of hydraulic distortion. As an auscultator, the clinician is superior to the graphic machine because he can perceive acoustic as well as visual patterns; he can anticipate and recognize distortions; and he can clarify certain problems by the ad hoc use of positional maneuvers.