Figure 200t Base and apex phonocardiograins are recorded
with the ACG in a patient having complete heart block with AV dissociation.
In the first and second complexes a prominent summation gallop (S3S4)
is recorded due to atrial contraction occurring during the rapid filling
phase of the left ventricle. In the third complex, atrial contraction
occurs later, and only minimal vibrations are present at the time of
the rapid filling wave of the ACG. In the first two complexes, the intensity
of S1 is soft, while in the third complex in the setting of a short
PR interval, there is marked increase in the mitral and tricuspid components
of S1. |