Exercise Phonocardiogram Significance of the Third and Atrial Sounds

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The amplitude changes of the third and atrial sounds before and after double MASTER'S two-step test were analysed in 60 cases of ischemic and/or hypertensive heart disease and 60 normal subjects using direct-writing phonocardiograph. After exercise both third and atrial sounds in the heart disease group showed greater increase in the amplitude and delay in restoration to the pre-exercise level than those of control group. The differences were statistically significant. In some cases with ischemic heart disease definite gallop rhythm developed after exercise despite negative MASTER'S test. First and second sounds, however, revealed no remarkable differences in post-exercise amplitude changes between two groups. Left ventricular hypotonicity and elevation of the end-diastolic pressure may be responsible for the accentuation of these diastolic extra-sounds in diseased group.

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