PHARMACOLOGICAL METHODS IN THE PHONOCARDIOGRAPHIC DIAGNOSIS OF REGURGITANT MURMURS

Abstract

The diagnosis of the source of regurgitant murmurs is an acute problem of contemporary cardio- logy in relation to the surgical treatment of valvular heart disease. The distinction between mitral and tricuspid systolic regurgitant murmurs may cause considerable difficulties even after assessment of the entire clinical picture, including detailed hemodynamic investigation. The inspiratory increase of the systolic murmur caused by tricuspid incompetence (Rivero-Carvallo, 1950) was found by Uricchio et al. (1958) in regurgitation of slight degree only and by Sepulveda and Lukas (1955) in a single patient out of ten. The differential diagnosis between incompetence of the aortic and pulmonary valves is even more difficult, particularly when not accompanied by significant haemodynamic changes.