CARDIOVASCULAR SYMPTOMS AND SIGNS

Summary The cardiomyopathy of Friedreich's ataxia is not associated with any characteristic symptoms and signs. However, ahnormal sound phenomena from the heart occur, and have been studied by phonocardiography. 1. More than one‐third of the probands were earlier suspected to have congenital heart disease, on the grounds of a murmur. In 6 patients, the murmur later evidently disappeared completely. 2. Phonocardiographic recordings show a systolic murmur of ejection type, with a maximum over the 2nd left interspace in 14 of 39 patients. The murmur is of higher frequency and amplitude, and begins later in systole, than is usual m a physiological murmur. 3. Anatomical and haemodynamic features may be responsible for the murmur. 4. A significantly higher incidence of murmur is found in the younger patients. A decreased stroke volume is suggested to explain the disappearance of the murmur in older patients. 5. A split second sound with an interval of more than 4 csec is present in about half of the cases. A probably significant correlation exists between abnormal splitting of the second sound and the occurrence of a systolic murmur of grade 2–4. 6. Accentuated, high‐frequent third and fourth sounds, causing gallop rhythm, are present in 8 cases.