Mintz G S, Kotler M N, Parry W R
Am J Med. 1979 Mar;66(3):523-7. doi: 10.1016/0002-9343(79)91094-5.
A patient is described with tricuspid valve endocarditis in whom the vegetation interfered with valve closure resulting in marked wide splitting of the first heart sound. M-mode and two-dimensional echocardiographic studies detected the presence of a vegetation. Simultaneous phonocardiographic and echocardiographic studies documented the marked delay in tricuspid valve closure and differentiated wide splitting of the first heart sound from other causes of early and mid-systolic sounds. Following pulmonary embolization, the first heart sound returned to normal. Echocardiographic disappearance of the vegetation of the tricuspid valve was also noted. Regrowth of the vegetation again produced the abnormal phonocardiographic and echocardiographic findings.
描述了一名患有三尖瓣心内膜炎的患者，其赘生物干扰了瓣膜关闭，导致第一心音明显增宽分裂。M型和二维超声心动图检查发现存在赘生物。同时进行的心音图和超声心动图研究记录了三尖瓣关闭的明显延迟，并将第一心音的增宽分裂与其他收缩早期和中期心音的原因区分开来。肺栓塞后，第一心音恢复正常。还注意到三尖瓣赘生物在超声心动图上消失。赘生物再次生长又产生了异常的心音图和超声心动图表现。
