Peripheral gangrene in polycythaemia vera.

well account for the phonocardiographic features of extreme variability of the A2-OC interval and the intermittent absence of the OC. The systolic murmur was in keeping with mitral reflux with its rate related variability. In a very ill patient with a malfunctioning mitral Starr-Edwards prosthesis we feel that the phonocardiographic findings can be a useful bedside adjunct to the physician and the cardiac surgeon in the assessment of prosthetic function when other methods may not be practicable.