Early systolic sounds in aortic valve stenosis.

The association of early systolic sounds with aortic valve disease has long been recognized (Potain, 1900; Oria's and Braun-Menendez, 1939). The genesis of this sound and indeed the timing in relation to aortic valve opening has been disputed. Some authors (Wolferth and Margolies, 1945; Wiggers, 1949; Minhas and Gasul, 1959) suggest that they occur at the time of aortic valve opening, while others (Leatham and Vogelpoel, 1954; Reinhold, Rudhe, and Bonham-Carter, 1955) postulate an origin in the aortic wall during the systolic ejection period. This has led to these sounds being variously termed early systolic clicks, and ejection sounds. For these reasons, a study was carried out in a group of patients with suspected aortic stenosis. The purpose of this study was to clarify the relationships between these sounds and left-sided pressure events, to assess the frequency and significance of such sounds, and to make observations relevant to their mechanism of production.