Observations on the Atrial Sound in Hypertension

Recovery from heart failure in hypertensive patients having an audible atrial sound was associated with decrease in the intensity of this sound and lengthening of the P-G interval. In most patients the atrial sound disappeared entirely. The rapid intravenous infusion of saline was invariably associated with the appearance of an audible atrial sound in 10 hypertensive patients with left ventricular disease. This procedure was ineffective in producing an audible atrial sound in nine normal subjects and in eight of nine hypertensive patients without left ventricular disease. In four hypertensive patients with left ventricular disease and an audible atrial sound, the infusion of saline resulted in increase in the intensity of the sound and shortening of the P-G interval. An audible atrial sound was most frequently found in association with left ventricular disease and elevation of atrial and ventricular diastolic pressures. The findings suggest that an audible atrial sound is frequently a manifestation of cardiac dysfunction.