The atrial sound in ischaemic heart disease.

A study was made of the diagnostic value of the atrial sound in ischaemic heart disease. It is shown that in ischaemic heart disease, whether or not infarction has occurred, an atrial sound is usually present and can be detected both clinically and phonocardiographically. Its absence makes the presence of ischaemic heart disease unlikely. In a clinical series of 276 consecutive cases of myocardial infarction an atrial sound was heard early in the illness in 98 per cent if thefew with dysrhythmias, mitral stenosis, and inaudible heart soundsfrom impending death are excluded. In a clinical and phonocardiographic study of 130 consecutive patients admitted to a coronary care unit, highly significant statistical significance is shown for the presence or absence of an atrial sound at the beginning of the illness in diagnosing the presence or absence of myocardial infarction. In So consecutive patients with angina and no evidence of infarction all had an atrial sound heard and recorded phonocardiographically. Electrocardiographic evidence of left atrial hypertrophy is common and occurred in 40 per cent of the patients studied. Atrial sounds occur in symptom-free middle-aged and older people and may indicate presymptomatic ischaemic heart disease. This group might repay further study.