PT  - JOURNAL ARTICLE
AU  - Y. Mishiro
AU  - T. Oki
AU  - N. Fukuda
TI  - Unusual left ventricular wall motion and a loud added sound during the isovolumic relaxation period in a patient with hypertensive heart disease.
AID  - 10.1136/hrt.77.3.290
DP  - 1997 Mar 01
TA  - Heart
PG  - 290--292
VI  - 77
IP  - 3
4099  - http://heart.bmj.com/content/77/3/290.short
4100  - http://heart.bmj.com/content/77/3/290.full
SO  - Heart1997 Mar 01; 77
AB  - A 69 year old woman with hypertensive heart disease had a loud added sound which coincided with a sudden interruption of the early diastolic motion of the left ventricular posterior wall, as visualised by M mode echocardiography, and came just before early diastolic transmitral flow, as measured by a pulsed Doppler echocardiogram. Early diastolic motion velocity from the base to the middle of the posterior wall, assessed by pulsed Doppler tissue imaging, was markedly high and sharp, and its peak coincided with the sound. A notch, similar to that in the posterior wall motion, occurred in the left ventricular pressure curve during early diastole. No intraventricular flow signal was detected during the isovolumic relaxation period, as measured by pulsed and colour Doppler imaging. The added sound was probably produced by impact between the dilated heart, with a relaxation abnormality, and the extracardiac structures during the isovolumic relaxation period.