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• W2065433080 abstract "In this day of emphasis upon clinical relevance, and the emphasis placed by governmental granting agencies upon directly applicable research, one wonders if there is any value in detailed investigations related to the mechanism of production of the second heart sound. Points of infinitesimal accuracy are debated, such as whether the second sound starts milliseconds before or after total semilunar valve closure, or whether vibration of nonvalve structures participates in the closure sound. We believe that these issues are important and clinically relevant. Specifically, recent information related to the origin of the second sound permits one to interpret clinical auscultatory phenomena that previously were puzzling and sometimes seemingly paradoxical. In 1915 Wiggersl suggested that there is silent approximation of the semilunar valves and that aftervibrations of the closed valves and the column of blood produce the second heart sound. In 1938 Lewis and Dock2 indicated that the second sound is of purely valve origin and excluded the myocardium as a structure contributing to the heart sounds. Studies a century earlier by Rouanet3 indicated that heart sounds (in this case the first sound) could be caused in a fashion similar to sound produced by any membrane as it passes “from flaccidity to tension suddenly.” In recent years, many factors have been postulated to contribute to sound production although experimental evidence has been limited in some instances. Rushmer4 related the origin of the second sound to oscillations in the arterial and ventricular cavities initiated by the momentum of backward-moving blood, which causes stretch and subsequent recoil of the valve. Coleman5 attributed the second sound to the sudden snapping together of the corpora arantii, which he postulated provides sufficient energy to vibrate the tensed leaflets. Piemme et al.6 suggested that the main" @default.
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• W2065433080 date "1978-01-01" @default.
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• W2065433080 title "Origin of the second heart sound: Clinical relevance of new observations" @default.
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• W2065433080 doi "https://doi.org/10.1016/0002-9149(78)90140-6" @default.
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