The presence of a third heart sound in patients with incompetent mitral heterografts challenges the physiological theory that the sound is produced by sudden tautening of mitral valve structures.
Challenges tautening theory of third heart sound; hypothesis-generating from case reports and should not change practice.
Three cases of severe mitral incompetence after heterograft aortic valve replacement are described. In all cases an early third heart sound was recorded on the phonocardiograms. In two cases a prominent early diastolic peak was also recorded on the apex cardiograms. These findings do not support the widely held view that the third heart sound is produced by sudden tautening of the mitral valve structures during the rapid filling phase of the left ventricle.
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Gamal et al. (1970) studied this question.
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