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(Chest. 1971;59:316-319.)
© 1971 American College of Chest Physicians

Triplication and Quadruplication of the Second Sound

Aldo A. Luisada M.D., F.C.C.P.1 and Beatrice Argano M.D.1

1 Division of Cardiology (Medicine), Chicago Medical School, University of Health Sciences, and the Mount Sinai Hospital Medical Center Chicago

A survey of phonocardiograms has shown that 8 percent of subjects with normal hearts or innocent murmurs have a triplication of the second sound due to an early-diastolic sound. Hypertensive patients

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present this in 12 percent of cases, while 18 percent of patients with atrial septal defect have it. This extra sound is explained as a vibration occurring soon after opening of the mitral valve. Rare cases have a double opening sound.

Occasionally, one can find another type of triplication due to a double aortic component.

A dynamic explanation of these facts is given.






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Copyright © 1971 by the American College of Chest Physicians.