Phonocardiographic timing of third and fourth heart sounds during acute myocardial infarction.
A 47-year-old diabetic woman was referred for diagnostic coronary angiography as part of an evaluation before renal transplantation. During attempts to cannulate the left coronary artery, the patient developed severe dyspnea and new ST-segment elevations in the anterior leads. Left coronary angiography showed acute occlusion of the proximal left anterior descending (LAD) coronary artery. She then underwent emergent percutaneous intervention of the occluded vessel. Continuous electrocardiographic and phonocardiographic recordings were obtained during the procedure that documented the timing and appearance of ST-segment elevations and the onset of third and fourth heart sounds. In this report, the sequence of these events is discussed, and the literature is reviewed.
Harris
Ian S
IS
Division of Cardiology, Department of Medicine, University of California-San Francisco Medical Center, San Francisco, CA 94143-0124, USA.
Lee
Eunyoung
E
Yeghiazarians
Yerem
Y
Drew
Barbara J
BJ
Michaels
Andrew D
AD
D003327:Coronary Disease / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006347:Heart Sounds; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000209:etiology*; D010701:Phonocardiography / Q000379:methods*