PHONOCARDIOGRAPHY IN ACYANOTIC CONGENITAL HEART DISEASE

Abstract

The phonocardiographic data in 210 cases of acyanotic congenital heart disease were studied, with particular reference to correlation of phonocardiograms with auscultatory findings noted at the bedside and with physiologic data (such as blood pressure and flow) obtained by cardiac catheterization or during surgical procedures. Examples of a wide variety of lesions are presented and discussed. Congenital cardiac lesions are manifested by certain characteristic murmurs and sounds which are modified in a predictable manner by the physiologic disturbances secondary to the cardiac defect (such as pulmonary hypertension of varying degrees). Although the lesions often can be diagnosed by auscultation alone, the correlations in this study indicate that phonocardiography is more precise than the ear in gauging the degree of the secondary disturbances. [See Fig. in Source Pdf.] As shown by representative tracings included in this report, phonocardiography records fine changes in the timing, configuration, duration, intensity and localization of cardiac sounds and murmurs which cannot always be detected by auscultation. The use of phonocardiography as an adjunct to auscultation results in more accurate assessment of the lesions of congenital heart disease and a greater understanding of the associated physiologic changes. This ultimately leads to a more rational basis for decisions which the physician must make regarding definitive treatment. With experience in correlating auscultatory and phonocardiographic findings, the physician often can improve his auscultatory accuracy but he can never equal the refinement of a good graphic recording.