Systolic clicks with ventricular septal defects. A sign of aneurysm of ventricular septum?

A series of 20 cases is described of children with ventricular septal defects, in whom it was thought that a systolic ejection sound was heard. These were recorded using an accelerometer phonocardiographic technique which was particularly useful in childhood and infancy. Ten of these cases showed an early systolic click, the other IO showed a split first heart sound. Three of the cases with a systolic ejection click were shown at angiocardiography to have an aneurysm of the interventricular septum. The relation between the ejection click and the aneurysm of the ventricular septum is discussed.