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Gallop rhythm in children studied by means of calibrated phonocardiography
SELECTED
465
ABSTRACTS
No striking alterations were noted in spinal fluid pressures. The rise following bilateral pressure on the jugular veins was diminished following the administration of these compounds (general vasoconstriction). Topical application of all compounds caused mydriasis. This was particularly striking foflowing the instillation of Veritol (0.5 per cent solution). HECHT. Carlgren, L. E.: cardiography.
Gallop-Rhythm Acta. paediat.
in Children 33: Suppl.
Studied 6, 1946.
by Means
of Calibrated
Phono-
A review of the etiology and characteristics of third heart sounds, auricular sounds, and The view is expressed that the third sound is various types of gallop rhyehms is presented. caused by vibrations of the ventricular wall secondary to the rapid inrush of blood into the ventricIes during early diastole. The auricular sounds are presumed to be formed by vibrations of both the ventricqlar muscle and the atrioventricular valves. An attempt is made to separate the normal third heart sound from protodiastolic gallop rhythm, and the normal auricular sound from an auricular gallop by the use of Mannheimer’s “calibrated” phoxiocardiograph. This instrument transmits the response of the recording microphone through various selective high and low pass filters to four oscillograph coils. A series of different frequency bands of heart sounds or murmurs may thus be recorded by separate channels simultaneously. The units are selective for frequency ranges of 0 to 175, 100 to 250, 17.5 to 400, and 250 to 1,000 cycles per second respectively. In children, the normal third heart sounds and the auricular sounds are of low voltage and display frequencies below 100 oscillations per second. Gallop rhythms occurring during the same phase of the cardiac cycle reveal greater amplitudes and have frequencies considerably above 100 cycles. Using these criteria, gallop rhythm was recognized in 104 children. Seventy-eight revealed protodiastolic gallop rhythms; two, auricular gallop; and twenty-four were classified as presenting a summation type of gallop. In sixty-four of these children no apparent heart disease was present, but in one-half of these myocardial damage could not be ruled out with certainty. Gallop rhythms of this type were frequently found in acute rheumatic fever but occurred only five times in 300 instances of congenital heart disease. Gallop rhythms occurred in rabbits four to six days following the injection of caffeine (0.25 Gm. per kilogram) and 0.2 mg. of epinephrine intravenously (Fleisher and Loeb). Myocardial lesions were thus produced in twenty-three of thirty rabbits and gallop rhythms were present in sixteen of the twenty-three animals. It was always found to be associated with excessive cardiac dilatation as demonstrated by x-ray. This favors the concept that a diminished tone of myocardial muscle is a prerequisite for the gallop rhythms. HECHT. Magro, Folia
G.: Intraventricular Cardiologica 5:439
Conduction (August), 1946.
on
Exercise:
A
Cardiac
Function
Test.
A method previously reported by Pachioli has been employed in which the duration of the QRS complex is measured before and after exercise (step test). The QRS complex before and after the test was enlarged and its duration measured with an accurate comparator. In ten normal individuals and in ten patients with cardiac neurosis a slight decrease in the width of QRS was noted, the degree being directly proportional to the increase in heart rate. Patients suffering from a variety of organic diseases of the heatt revealed a prolongation of QRS in most instances. The test is claimed to be of value in cases where organic heart disease is suspected in the face of normal electrocardiographic or roentgenographic findings at rest. HECHT. Gregersen, Mangus I., and Root, Walter S.: Experimental Traumatic Shock Produced by Muscle Contusion With a Note on the Effects of Bullet Wounds. A Study of the Clinical Signs of Shock in t$e Dog and of the Role of Blood Volume Reduction in the Development of the Shock Syndrove. Am. J. Physiol. 148:98 (Jan.), 1947. Experimental traumatic muscles on the anesthetized
shock animal.
was produced in thirty Only one dog failed
dogs by uniform contusion of the thigh to show the characteristic signs of shock.
465
ABSTRACTS
No striking alterations were noted in spinal fluid pressures. The rise following bilateral pressure on the jugular veins was diminished following the administration of these compounds (general vasoconstriction). Topical application of all compounds caused mydriasis. This was particularly striking foflowing the instillation of Veritol (0.5 per cent solution). HECHT. Carlgren, L. E.: cardiography.
Gallop-Rhythm Acta. paediat.
in Children 33: Suppl.
Studied 6, 1946.
by Means
of Calibrated
Phono-
A review of the etiology and characteristics of third heart sounds, auricular sounds, and The view is expressed that the third sound is various types of gallop rhyehms is presented. caused by vibrations of the ventricular wall secondary to the rapid inrush of blood into the ventricIes during early diastole. The auricular sounds are presumed to be formed by vibrations of both the ventricqlar muscle and the atrioventricular valves. An attempt is made to separate the normal third heart sound from protodiastolic gallop rhythm, and the normal auricular sound from an auricular gallop by the use of Mannheimer’s “calibrated” phoxiocardiograph. This instrument transmits the response of the recording microphone through various selective high and low pass filters to four oscillograph coils. A series of different frequency bands of heart sounds or murmurs may thus be recorded by separate channels simultaneously. The units are selective for frequency ranges of 0 to 175, 100 to 250, 17.5 to 400, and 250 to 1,000 cycles per second respectively. In children, the normal third heart sounds and the auricular sounds are of low voltage and display frequencies below 100 oscillations per second. Gallop rhythms occurring during the same phase of the cardiac cycle reveal greater amplitudes and have frequencies considerably above 100 cycles. Using these criteria, gallop rhythm was recognized in 104 children. Seventy-eight revealed protodiastolic gallop rhythms; two, auricular gallop; and twenty-four were classified as presenting a summation type of gallop. In sixty-four of these children no apparent heart disease was present, but in one-half of these myocardial damage could not be ruled out with certainty. Gallop rhythms of this type were frequently found in acute rheumatic fever but occurred only five times in 300 instances of congenital heart disease. Gallop rhythms occurred in rabbits four to six days following the injection of caffeine (0.25 Gm. per kilogram) and 0.2 mg. of epinephrine intravenously (Fleisher and Loeb). Myocardial lesions were thus produced in twenty-three of thirty rabbits and gallop rhythms were present in sixteen of the twenty-three animals. It was always found to be associated with excessive cardiac dilatation as demonstrated by x-ray. This favors the concept that a diminished tone of myocardial muscle is a prerequisite for the gallop rhythms. HECHT. Magro, Folia
G.: Intraventricular Cardiologica 5:439
Conduction (August), 1946.
on
Exercise:
A
Cardiac
Function
Test.
A method previously reported by Pachioli has been employed in which the duration of the QRS complex is measured before and after exercise (step test). The QRS complex before and after the test was enlarged and its duration measured with an accurate comparator. In ten normal individuals and in ten patients with cardiac neurosis a slight decrease in the width of QRS was noted, the degree being directly proportional to the increase in heart rate. Patients suffering from a variety of organic diseases of the heatt revealed a prolongation of QRS in most instances. The test is claimed to be of value in cases where organic heart disease is suspected in the face of normal electrocardiographic or roentgenographic findings at rest. HECHT. Gregersen, Mangus I., and Root, Walter S.: Experimental Traumatic Shock Produced by Muscle Contusion With a Note on the Effects of Bullet Wounds. A Study of the Clinical Signs of Shock in t$e Dog and of the Role of Blood Volume Reduction in the Development of the Shock Syndrove. Am. J. Physiol. 148:98 (Jan.), 1947. Experimental traumatic muscles on the anesthetized
shock animal.
was produced in thirty Only one dog failed
dogs by uniform contusion of the thigh to show the characteristic signs of shock.