Phonocardiography - Causes, symptoms and treatment. MF.

During its work, the heart continuously pumps blood through the body, which is due to rhythmic contractions of the heart muscle and a well-adjusted alternate operation of the valve apparatus. These processes are accompanied by sounds that can be heard by attaching to the chest an ear or a special instrument - a doctor's phonendoscope. If there are any diseases in the heart, it is accompanied by pathological sounds - changes in tones, noise or clicks. For example, for each type of heart disease, certain combinations of sound phenomena are characteristic.

But not always only with the help of a phonendoscope it is possible to distinguish between noises and to presume one or another diagnosis. Then the doctor can prescribe to the patient an additional method of examination - phonocardiography.

This is a research method based on the amplification of sounds arising during the operation of the internal structures of the heart, as well as on their recording with subsequent evaluation of the obtained curves. In the process of research, microphones are attached to the front chest at six points of the best listening of the heart valves, which translate the sound vibrations into electrical vibrations. The signals are then processed by a phonocardiograph and recorded as curves using an ink recorder or photographic paper. For a more convenient evaluation of sound phenomena, recording is performed simultaneously with the recording of the electrocardiogram.

The advantages of the method include safety, availability, informative, non-invasive, the possibility of repeated examination. Complications during the procedure do not develop.

Phonocardiography was previously used widely enough, but was gradually replaced by clinical practice with a more accurate study - echocardiography( ultrasound of the heart).In recent years, there is no need to record and interpret sound changes, since the ultrasound of the heart allows you to visualize, "see" the defect, and this will bring more diagnostic benefit than "hearing" the indirect signs of the same blemish.

Indications for the

survey The main indication for referral is to listen to the doctor when examining the noise or pathological tones found mainly in congenital or acquired heart defects:
- stenosis and / or insufficiency of the mitral, tricuspid, aortic valve and pulmonary valve,
- defects of interatrial and interventricular septa, open Botallov duct, congenital stenosis of the aorta and pulmonary artery,
- rheumatism with heart damage - revmokardit, for the timely detection of the emerging heart defect.

The study can be shown with the following complaints:
- severe dyspnea on walking, episodes of choking at rest,
- palpitations, arrhythmias at rest or with exercise,
- frequent dizziness accompanied by loss of consciousness( due to reduced blood flow to the brain,for example, with aortic insufficiency),
- pain in the region of the heart of a different nature, especially in young people.

Contraindications to phonocardiography

Is it possible to conduct a survey? Contraindications for this method of diagnosis does not exist, so it can be carried out repeatedly by both adults and children. The study may be difficult in the case of severe injuries, chest burns, severe obesity and other concomitant conditions that make it difficult to fit the microphone tightly to the skin of the breast.

Explanation of results

What can you learn about this method? When receiving the results, the doctor, analyzing the presence of pathological sound phenomena, their amplitude, location and correspondence to the phases of the cardiac cycle, can make a complete picture of the presence of a particular heart defect in the patient.

On the graphical curve, the sound vibrations are represented by dashes, and the more intense the sound, the higher and denser the strokes are. Normally, only two tones are recorded on the phonocardiogram - the first and second heart tones that appear in the systole( contraction) and the diastole( relaxation) of the heart muscle. In the case of defects, the changes in the stroke and curve of the curve, corresponding to different phases of the cardiac cycle, are different in amplitude and pattern. For example, in aortic stenosis, systolic murmur of rhomboid shape is recorded; in mitral stenosis, the first tone and presystolic noise are amplified in amplitude; in case of tricuspid valve insufficiency, ribbon-like systolic murmur with low amplitude, with aortic insufficiency, proto- diastolic noise, etc.

In addition to the pathological noise accompanying heart defects, functional noise( especially common in children), as well as noise accompanying anemia or arterial hypertension, can be recorded when recording a phonocardiogram.

Patients should remember that an independent interpretation of the conclusion is not permissible, as only a physician of functional diagnostics and a cardiologist can correct the results.

Doctor therapist Sazykina O.Yu.