second heart sound

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出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2013/01/08 21:39:33」(JST)

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英文文献

  • Evaluation of the use of atropine sulfate, a combination of butylscopolammonium bromide and metamizole sodium, and flunixin meglumine to ameliorate clinical adverse effects of imidocarb dipropionate in horses.
  • Abutarbush SM, Alfaqeeh SM, Mustafa G, Qura'n L, Al-Majali AM.Author information Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan.AbstractOBJECTIVE: To evaluate the ability of atropine sulfate, butylscopolammonium bromide combined with metamizole sodium, and flunixin meglumine to ameliorate the clinical adverse effects of imidocarb dipropionate in horses.
  • American journal of veterinary research.Am J Vet Res.2013 Nov;74(11):1404-8. doi: 10.2460/ajvr.74.11.1404.
  • OBJECTIVE: To evaluate the ability of atropine sulfate, butylscopolammonium bromide combined with metamizole sodium, and flunixin meglumine to ameliorate the clinical adverse effects of imidocarb dipropionate in horses.ANIMALS: 28 horses with piroplasmosis.PROCEDURES: 28 horses were randomly assigne
  • PMID 24168305
  • Modeling of heart sound morphology and analysis of the morphological variations induced by respiration.
  • Tang H, Gao J, Ruan C, Qiu T, Park Y.Author information Department of Biomedical Engineering, Dalian University of Technology, Dalian 116024, China. Electronic address: tanghong@dlut.edu.cn.AbstractIn this study, each peak/valley of a heart sound was modeled by a Gaussian curve and characterized by amplitude, timing, and supporting width. This model was applied to analyze the morphological variations induced by respiration in 12 subjects. It was observed that the morphology exhibited regular behaviors with respiration. The amplitude of the prominent peaks and valleys of S2 (the second heart sound) were commonly attenuated during expiration and were accentuated during inspiration whereas no consistent observations were obtained for S1 (the first heart sound). The supporting width of S1 commonly decreased with expiration and increased with inspiration whereas the supporting width of S2 displayed no significant changes during respiration. For all subjects, the delay of S1 increased during inspiration and decreased during expiration. However, the delay of the aortic component increased during expiration and decreased during inspiration. The pulmonary component of S2 was observed in 7 of 12 subjects, and the delay was opposite to that of the aortic component. The opposing delays yielded a splitting between the two components of S2 that increased during inspiration and decreased during expiration. The delay pattern was the most consistent observation in all subjects. These results suggest that a quantitative analysis of morphological variations, particularly the delay pattern, could be used as a non-invasive continuous monitoring method of hemodynamic change during respiratory cycles.
  • Computers in biology and medicine.Comput Biol Med.2013 Nov;43(11):1637-44. doi: 10.1016/j.compbiomed.2013.08.005. Epub 2013 Aug 20.
  • In this study, each peak/valley of a heart sound was modeled by a Gaussian curve and characterized by amplitude, timing, and supporting width. This model was applied to analyze the morphological variations induced by respiration in 12 subjects. It was observed that the morphology exhibited regular b
  • PMID 24209908
  • Juvenile severe mitral stenosis predisposing Eisenmenger syndrome in a case with ventricular septal defect, patent ductus arteriosus, coarctation of aorta & hypoplastic aortic arch: Report of first case of rare association.
  • Patra S, Kumar B, Sadananda KS, Krishnappa S, Basappa H, Nanjappa MC.Author information Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Mysore Branch, Bangalore 560069, Karnataka, India.AbstractWe are reporting the first case of rare association between multiple congenital cardiac malformations with severe rheumatic mitral stenosis which is an acquired structural cardiac disease. A 16 years old female patient presented with progressive dyspnoea & cyanosis for the last one month with past history of recurrent pneumonia since infancy. Physical examination revealed presence of cyanosis, grade I clubbing, radio-radial & radio-femoral delay, loud & single second heart sound, apical long mid diastolic murmur and left parasternal ejection systolic murmur. Transthoracic echocardiography revealed severe rheumatic mitral stenosis, multiple ventricular septal defects (VSD) with bidirectional shunt, hypoplastic aortic arch, Coarctation of aorta and severe pulmonary hypertension. Transesophageal echocardiography revealed the same findings along with the presence of moderate mitral regurgitation and 9 mm perimembranous VSD extending into muscular septum. Cardiac catheterization study confirmed the echocardiographic findings and demonstrated large patent ductus arteriosus (PDA). We have planned for high-risk percutaneous transmitral commissurotomy (PTMC) for this patient to decrease the back pressure on pulmonary vasculature. So that right to left shunt will be decreased and cyanosis will also improve. But parents refused to give consent for PTMC. She was on treatment with regular penicillin prophylaxis, diuretics, sildenafil and infective endocarditic prophylaxis. We should be aware of this kind of complex association between congenital and acquired structure heart disease. Eisenmenger syndrome could also be a presentation of juvenile severe rheumatic mitral stenosis when it is associated with congenital shunt lesion like VSD/PDA in our case.
  • Journal of cardiovascular disease research.J Cardiovasc Dis Res.2013 Sep;4(3):195-7. doi: 10.1016/j.jcdr.2013.05.006. Epub 2013 Aug 20.
  • We are reporting the first case of rare association between multiple congenital cardiac malformations with severe rheumatic mitral stenosis which is an acquired structural cardiac disease. A 16 years old female patient presented with progressive dyspnoea & cyanosis for the last one month with pa
  • PMID 24396261

和文文献

  • 見神と自然をめぐる思索と交錯 : 綱島梁川と内村鑑三
  • 柴田 真希都
  • 宗教研究 85(1), 125-149, 2011-06-30
  • 本稿は、神との出会いにおける自然の役割や位置づけという観点から、綱島梁川と内村鑑三を取り上げる。梁川の見神の実験(一九〇五年)に端を発する見神流行の最中に、鑑三は「真の見神とは何か」という問いをたてる。彼は自身の生活経験と聖書研究から、梁川の見神記述にはない二つの見神の方途を導く。一つは<イエスを介して>であり、もう一つは<自然を通して>であった。鑑三は以後も、聖書研究を通 …
  • NAID 110008686220
  • Integrated backscatter intravascularultrasound(IB-IVUS)を用いた急性冠症候群における冠動脈ステント留置によるプロラプス予測の試み:—緊急血行再建における1断面での評価
  • 田中 新一郎,野田 俊之,瀬川 知則,岩間 眞,皆川 太郎,渡辺 佐知郎,湊口 信也
  • Shinzo 43(1), 33-41, 2011
  • 目的: 急性冠症候群におけるステント留置を行う際, ストラットより組織が浸潤するプロラプス(tissue prolapse within stent struts; TP)は, 臨床上問題点が多い. Integrated backscatter intravascular ultrasound(IB-IVUS)により, 血行再建における心筋酵素の逸脱の予測が可能とされるが, 容積の評価など時間と手 …
  • NAID 130002146721
  • High-Frequent and Spontaneously Diminishing Noises after Shock: A Case of Rare Trouble in Replacement of Implantable Cardioverter-Defibrillator
  • Shimoshige Shinya,Mochizuki Atsushi,Kawamukai Mina,Nishida Junichi,Kohzu Hidemichi,Muranaka Atsuko,Kokubu Nobuyuki,Yuda Satoshi,Hase Mamoru,Hashimoto Akiyoshi,Tsuchihashi Kazufumi,Miura Tetsuji
  • Journal of Arrhythmia 27(Supplement), 2, 2011
  • … A 54-year-old male patient, who had received implantable cardioverter-defibrillator (ICD) for Brugada syndrome in 2002, visited our clinic for alert sound in March 2011. …
  • NAID 130002130062

関連リンク

In healthy adults, there are two normal heart sounds often described as a lub and a dub (or dup), that occur in sequence with each heartbeat. These are the first heart sound (S1) and second heart sound (S2), produced by the closing of the AV ...
This delay in P2 versus A2 is heard as a slight broadening or even "splitting" of the second heart sound; though it is usually only heard in the pulmonic area of the chest because the P2 is soft and not heard in other areas. During expiration, the ...

関連画像

second heart sound1st & 2nd Heart SoundsSecond heart sound - S2Second heart sound 110bpm.png of fallot second heart sound loud a2Heard well over the precordium; loudest at


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先読みII音
関連記事sound」「second」「heart」「hearing」「hear

II音」

  [★]

second heart sounds, S2
心音

まとめ

II音亢進 IIA 高血圧 AR 動脈硬化
IIP 肺高血圧 PR MS
II音減弱 IIA 低血圧 AS  
IIP   PS  

II音増大

MSとASとでは、同じstenosisでも心音の大きさに関与の仕方が違うんですね。
拡張期における大動脈圧、肺動脈圧が高い → 弁に衝突する血液の流速が早い → 弁の閉鎖音が大きい
  • 動脈硬化の強いとき
  • 大動脈弁が閉じるとき、拡張期早期 back pressureが高い?
  • 拡張期に大動脈弁を挟んだback pressureが高いから?
  • 右室へのvolume load。PHで顕著

II音減弱

  • 駆出できる血液量がへるから?

分裂音

呼吸性分裂

PHD.33-35
  • 生理的状態では、
  横隔膜の相対的位置 II音
呼気 expiration single sound
吸気 inspiration _ | | splitting sound
  • (1)吸気時には、肺の血管抵抗性が低下 → 拡張期におけるP弁へのback pressureは呼気時と比べ比較的低下する →P弁の開放時間が延長
  • (2)吸気時には、肺静脈が拡張 → 左房・左室への血液還流量が減少 → 左室を充満する血液量減少 → 一回拍出量減少 → 駆出時間の短縮 → A弁の開放時間が短縮

widened splitting

  • right bundle branch block(RBBB), pulmonic stenosis(PS)
IIAが早まる:MR, VSD
IIPが遅れる:RBBB, PS, pulmonary hypertension

固定性分裂 fixed splitting

奇異性分裂 paradoxical splitting

単一II音 single S2


sound」

  [★]

  • n.
  • v.
  • 響く
  • adj.
  • 健全な
Use of the amblyopic eye is encouraged by discouraging use of the sound eye with an occluding patch or using drugs or glasses to blur vision in the sound eye.
salutarytone

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「thorough; "a sound thrashing"」

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「mechanical vibrations transmitted by an elastic medium; "falling trees make a sound in the forest even when no one is there to hear them"」

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「the particular auditory effect produced by a given cause; "the sound of rain on the roof"; "the beautiful sound of music"」

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「the subjective sensation of hearing something; "he strained to hear the faint sounds"」
auditory sensation

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「a large ocean inlet or deep bay; "the main body of the sound ran parallel to the coast"」

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「the sudden occurrence of an audible event; "the sound awakened them"」

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「make a certain noise or sound; "She went `Mmmmm''"; "The gun went `bang''"」
go

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「announce by means of a sound; "sound the alarm"」

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「appear in a certain way; "This sounds interesting"」

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「cause to sound; "sound the bell"; "sound a certain note"」

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「financially secure and safe; "sound investments"; "a sound economy"」

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「free from moral defect; "a man of sound character"」

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「give off a certain sound or sounds; "This record sounds scratchy"」

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「in good condition; free from defect or damage or decay; "a sound timber"; "the wall is sound"; "a sound foundation"」

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「〈C〉〈U〉『音』,『音響』,響き・〈U〉音の聞こえる範囲・〈C〉(音声としての)音 / 《単数形で》(聞いたり,読んだりしたときに受ける)感じ,響き,調子・〈U〉(無意味な)音(声);騒音,ざわめき・『音を出す』,鳴る,響く・『聞こえる,思える』(進行形にできない) ・〈楽器・ベルなど〉‘を'鳴らす・(音で)…‘を'知らせる・…‘を'発音する・〈考えなど〉‘を'打診する」

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「(物が)『傷んでいない』,腐っていない,完全な / (心身が)『健全な』,健康な / (財政的に)『安定した』,堅実な / (論理・判断などが)『的確な』,もっともな,分別ある / 合法的な / (道徳的に)高潔な,誠実な / (睡眠が)深い / 徹底した,思う存分の / ぐっすりと」

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「(重りのついた糸で)〈海・川など〉‘の'水深を測る / (…について)〈意見・態度など〉‘を'さぐる,調べる《+『名』+『out』(+『out』+『名』)+『about』+『名』》 / 水深を測る / 〈鯨・魚などが〉深く潜る」

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「海峡,瀬戸(strait) / 入り江」


second」

  [★]

  • n.
  • adj.
  • 第二の、二次の
quadraticssecsecond-ordersecondarysecondly

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「transfer an employee to a different, temporary assignment; "The officer was seconded for duty overseas"」

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「a 60th part of a minute of arc; "the treasure is 2 minutes and 45 seconds south of here"」
arcsecond

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「1/60 of a minute; the basic unit of time adopted under the Systeme International d''Unites」
sec, s

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「following the first in an ordering or series; "he came in a close second"」

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「a speech seconding a motion; "do I hear a second?"」
secondment, endorsement, indorsement

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「the official attendant of a contestant in a duel or boxing match」

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「coming next after the first in position in space or time or degree or magnitude」
2nd, 2d

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「give support or one''s approval to; "I''ll second that motion"; "I can''t back this plan"; "endorse a new project"」
back, endorse, indorse

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「in the second place; "second, we must consider the economy"」
secondly

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「a part or voice or instrument or orchestra section lower in pitch than or subordinate to the first; "second flute"; "the second violins"」

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「《通例the~》『第2の』,2番目(2度目)の《略》『2nd,sec.』) / 《A~+名で》『もう一つの』,別の / 一級(最上)のものに次ぐ,二流の / (自動車の変速機の)第2速の / 低音(声)部の,第2の / 〈C〉《the~》『2番目の人』(『物,事』) / 〈U〉《the~》(月の)『第2日』 / 〈C〉(ボクシングの)セコンド;(決闘などの)介添人;(一般に)援助者 / 〈C〉《しばしば複数形で》二流品(ボタンが取れているなど、比較的小さな問題のある格安の服)・〈C〉〈U〉2度音程,第2音(声)部 / 〈U〉(自動車の変速機の)第2速,セカンド[ギア] / 《the~》《最上級の形容詞を伴って》第2に,2番目に / 第2位で,2等で / 〈提案・動議など〉‘に'賛成する,‘を'支持する / …‘を'援助する,後援する,激励する;(ボクシングで)…‘の'セコンドを務める」

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「(時間・角度の)『秒』 / 《単数形で》『瞬間』(moment)」


heart」

  [★] 心臓

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「a plane figure with rounded sides curving inward at the top and intersecting at the bottom; conventionally used on playing cards and valentines; "he drew a heart and called it a valentine"」

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「the courage to carry on; "he kept fighting on pure spunk"; "you haven''t got the heart for baseball"」
mettle, nerve, spunk

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「an inclination or tendency of a certain kind; "he had a change of heart"」
spirit

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「a playing card in the major suit that has one or more red hearts on it; "he led the queen of hearts"; "hearts were trumps"」

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「the locus of feelings and intuitions; "in your heart you know it is true"; "her story would melt your bosom"」
bosom

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「the hollow muscular organ located behind the sternum and between the lungs; its rhythmic contractions move the blood through the body; "he stood still, his heart thumping wildly"」
pump, ticker

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「a firm rather dry variety meat (usually beef or veal); "a five-pound beef heart will serve six"」

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「〈C〉『心臓』;胸 / 〈C〉(感情の中心をなす)『心』,気持ち / 〈U〉愛情,同情 / 〈U〉『勇気』,元気,熱意 / 《the ~》『中心』,内部,(物事の)本質,核心 / 〈C〉ハート形の物;(カードの)ハートの札」

hearing」

  [★]

  • n。
  • 聴力聴覚。聞くこと、聴取。聞こえる距離/範囲。聞いてやること、傾聴。聞いてもらうこと、発言の機会。(委員会などの)聴聞会、ヒアリング。(法)審問、尋問。

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「able to perceive sound」

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「an opportunity to state your case and be heard; "they condemned him without a hearing"; "he saw that he had lost his audience"」
audience

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「(law) a proceeding (usually by a court) where evidence is taken for the purpose of determining an issue of fact and reaching a decision based on that evidence」

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「the ability to hear; the auditory faculty; "his hearing was impaired"」
audition, auditory sense, sense of hearing, auditory modality

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「a session (of a committee or grand jury) in which witnesses are called and testimony is taken; "the investigative committee will hold hearings in Chicago"」

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「〈U〉『聴力』,聴覚〈U〉〈C〉(…を)『聞くこと』,(…の)聞き取り《+『of』+『名』》・〈C〉聞いてもらう機会,聞いてやること・聴取・聴聞会〈C〉(法廷などでの)尋問,審問,;(刑罰の減免を求める)釈明,意見陳述 / 〈U〉聞こえる距離(範囲)」

hear」

  [★]

  • v.

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「receive a communication from someone; "We heard nothing from our son for five years"」

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「〈音〉‘が'『聞こえる』,‘を'聞く(進行形にできない) / 〈人の言うこと〉‘に'『耳を傾ける』,‘を'注意深く聞く(listen);(裁判官などが)…の申し立てを聞く / 〈うわさ・ニュースなど〉‘を'『耳にしている』,聞いている / 『耳が聞こえる』 / 《しばしば命令形で》耳を傾ける,注意を向ける / 『うわさ』(『消息』)『を聞く』」

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「examine or hear (evidence or a case) by judicial process; "The jury had heard all the evidence"; "The case will be tried in California"」
try

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「perceive (sound) via the auditory sense」



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