PHONOCARDIOGRAPHY IN PULMONARY STENOSIS: SPECIAL CORRELATION BETWEEN HEMODYNAMICS AND PHONOCARDIOGRAPHIC FINDINGS

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Abstract
This study attempts to correlate hemodynamic findings and phonocardiographic (PCG) alterations in 56 cases of proved pulmonary stenosis (PS). In the group of isolated PS it was possible to estimate the degree of severity on the basis of duration, beginning, time accentuation, ending of the murmur, and A2-P2 (aortic valve closure to pulmonic valve closure) interval. The duration of right ventricular (RV) systole was also a good index of severity. PCG features of PS and ventricular septal defect (including tetralogy of Fallot) was indistinguishable in many cases from isolated PS. Nevertheless, the presence of a short pulmonic systolic murmur, single and loud second sound, and a venous tracing with prominent "a" wave suggested the presence of this condition. The group of PS with atrial septal defect presented phonocardiographic findings of severe isolated pulmonary stenosis with giant "a" waves in the venous tracing. The PCG findings were correlated with RV pressure, pressure gradient across the pulmonary valve and RV work.