SINO-AURICULAR BLOCK ASSOCIATED WITH INTRA-THORACIC NEW GROWTHS

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Abstract
Synchronous tracings of intracardiac pressures, phonocardiograms, and ecgs were obtained from 27 patients with mitral valve disease in order to examine the relationship between intracardiac pressure s and the time of occurrence of the first heart sound and opening snap. Correlation between the R-M1 interval (i.e. the interval between the onset of the intrinsicoid deflection of the ecg, R, and the onset of the maximal vibrations of the first heart sound, M1) and left atrial pressure was poor. The pressure always appeared to be raised when the R-M1 interval was prolonged, but the converse was not true. The authors believe that these discrepancies are probably due to differences in the rate of rise of left ventricular pressure with the R-M1 being shortened back to normal limits by a rapid rise. Correlation between the A-OS interval (i.e. the interval from the onset of the first component of aortic valve closure, A, to the opening snap, OS, measured on the phonocardiogram) showed a fair correlation with the coincident left atrial pressure. Other factors influencing this relationship were thought to be cardiac output and aortic pressure.

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