Effect of norepinephrine on the phonocardiographic, auscultatory and hemodynamic features of congenital and acquired heart disease

Abstract

The effect of intravenous administration of norepinephrine on the ausculttory and phonocardiographic features was studied in seventy-nine patients with congenital or acquired heart disease. The investigation was carried out during cardiac catheterization in twenty-three, making possible the observation of the hemodynamic consequences of the infusion. During the pressor response, accentuation of systolic and early diastolic and continuous murmurs was seen, with only rare exceptions; middiastolic murmurs were not altered. With reference to the cardiac sounds, increased intensity of P 2 was the most significant finding. This allowed determination of the degree of splitting of the second sound which is of importance in the evaluation of severity in pure pulmonary stenosis, particularly after valvotomy. It is mainly by intensifying faint signs, which thus become easy to identify, that administration of norepinephrine may offer auxiliary information helpful at the bedside and in phonocardiography. More information regarding the presence and localization of abnormal communications was derived by observing the behavior of the systemic and right ventricular or pulmonary arterial pressures under the influence of norepinephrine.