This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by SHAH, P. M. Articles by LUISADA, A. A. Search for Related Content PubMed PubMed Citation Articles by SHAH, P. M. Articles by LUISADA, A. A.

(Circulation. 1963;28:1102.)
© 1963 American Heart Association, Inc.

---

Spread of the "Mitral" Sound over the Chest

A Study of Five Subjects with the Starr-Edwards Valve

P. M. SHAH M.D.¹; D. M. MACCANON PH.D.¹; A. A. LUISADA M.D.¹

¹ From the Division of Cardiovascular Research and the Department of Medicine (Division of Cardiology), The Chicago Medical School, Chicago, Illinois.

Five subjects with prosthetic Starr-Edwards valve replacement of the mitral valve were studied in order to delineate the transmission characteristics of the sounds produced by this valve. In sharp contrast to the first (so-called "mitral") component of the first sound, this sound, arising at the mitral ring, arrived earlier on the surface of the chest in the third and fourth left interspaces near the sternal edge as compared to the apex. This was well correlated to the location of the prosthetic valve as seen from roentgenogram of the chest. It is concluded that the transmission of sound from the prosthetic mitral valve is mainly in the form of transverse vibrations. Different transmission characteristics of this sound, as compared to the first component of the first heart sound, indicate a different source for the two sounds.