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The loud 1st heart sound in left atrial myxoma

, : The loud 1st heart sound in left atrial myxoma. British Heart Journal 52(4): 403-407

The interrelation between the loudness of the 1st heart sound, the time interval from the Q wave to the onset of the 1st heart sound (QM1), and the mitral valve closure rate was studied in 9 patients presenting with left atrial myxomata. In 7 patients the 1st heart sound was loud preoperatively and was associated with delayed mitral valve closure. After removal of the myxoma the onset of mitral valve closure returned towards normal, the mitral valve closure rate was reduced and the 1st heart sound became softer. In 2 patients the 1st heart sound was normal before and after operation as were the time of onset of mitral valve closure and the mitral valve closure rate. In neither of these patients did the myxoma completely fill the mitral orifice during diastole. The loud 1st heart sound in left atrial myxoma is a useful clinical sign and its intensity is directly related to the delay in onset of closure of mitral leaflets.

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