Resting and Postexercise Phonocardiogram and Electrocardiogram in Patients with Angina Pectoris and in Normal Subjects

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Abstract
One hundred patients with angina and 100 normal subjects, mean age 51 years, had simultaneous phonocardiograms and electrocardiograms at rest and after a double Master's test. A fourth heart sound was present at rest in 43% of the patients and 14% of the normal subjects, and after exercise in 94% of the patients and 29% of the normal subjects. All patients and the normal subject who had a third heart sound at rest had a fourth heart sound at rest, and all who had a third heart sound after exercise had a fourth heart sound after exercise. Fifty-nine per cent of the patients and 4% of the normal subjects had an ST-segment shift ≥1.0 mm, and 67% of the patients and 6% of the normal subjects had an ST-segment shift ≥0.5 mm. After exercise, 97% of the patients and 30% of the normal subjects had a fourth heart sound or an ST-segment shift ≥0.5 mm.