Heart Sounds and Pressures in Atrial Septal Defect.

The existence of a large communication between the atria allows detailed study of sounds and pressures in the four heart chambers and the pulmonary arteries. Only the aorta is inaccessible to the cardiac catheter. In uncomplicated atrial septal defect, moreover, pressures within the heart chambers are almost normal. There are no important pressure gradients across the valves. It seems likely, therefore, that valve movements in this condition will resemble fairly closely those of the normal heart. Using a saline-filled catheter and external manometer, previous authors have related sounds recorded at the prncordium to intracardiac pressure curves (Leatham and Gray, 1956; Dimond and Benchimol, 1959; Eisenberg and Hultgren, 1959). Sounds have also been recorded within the heart using a microphone mounted at the tip of a catheter and related to the conventional pressure records (Liu and Jacono, 1958; Feruglio and Sreenivasan, 1959; Lewis et al., 1959). In an earlier paper (Barritt and Davies, 1963), we have described the use of the Allard Laurens intracardiac manometer and referred to the extensive observations of Soulie's team in congenital heart disease (Soulie et al., 1961). This paper reports an analysis of records obtained with the intracardiac manometer in 23 patients with uncomplicated ostium secundum atrial septal defect.