Auscultation of the Heart—Early Neonatal Period

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Abstract
Although the physiological changes which occur in the cardiovascular system of the normal newly born infant have been the subject of increasing investigation, little attention has apparently been paid to the clinical phenomena that accompany these changes. Burnard1 reported a loud second heart sound immediately after birth, but found no constant pattern in its later development. Hallidie-Smith2 reported splitting of the first and second sounds, but did not correlate these findings with the age of the patients. A pilot study by one of us3 of healthy term infants in the first 4 hours of life, revealed an accentuated and single or finely split second heart sound, and in the babies studied after the second day of life a moderately wide splitting of the second heart sound was noted. In an extension of this report, serial auscultation of 50 healthy term infants in the first 3 days of

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