W. Rutishauser

Heart sounds in atrial tumors.

Abstract The phonocardiograms in three cases of atrial tumors are analyzed. The cases included one left-sided, one right-sided and one bilateral atrial tumor. There was marked homolateral shortening of systolic duration in two cases. Shortening of systole is compared with findings in stenosis of the mitral and tricuspid valves. One case with predominantly right-sided atrial tumor showed abnormally large respiratory variations in the splitting of the heart sounds and in the length of right and left ventricular systole. The pulse pressure of the pulmonary artery paralleled the systolic duration of the right ventricle. The exaggerated respiratory variations disappeared after surgical removal of the tumor. The following phonocardiographic signs should suggest the presence of an obstructive atrial tumor or thrombus: marked unilateral shortening of mechanical systole; exaggerated variation of systolic length with breathing, with postural changes, or within a short period of time. The phonocardiogram is an important diagnostic aid, particularly in the diagnosis of right atrial tumors, as there are few signs and clinical diagnosis seemed impossible as recently as fifteen years ago.