Abstract
Systolic venous pulsations in two patients with tricuspid insufficiency were accompanied by a single loud sound heard in the neck and in the groin. In one of the patients, the sound in the groin was followed by a short rumbling murmur. Pressure tracings revealed that the sounds occurred at the moment of rapid rise in pressure in the underlying vein. In the groin the sound lagged behind the onset of rise in femoral arterial pressure; hence, the sound arose in the vein and not in the artery. Venous sounds may be produced by a rapid rise of venous pressure due to either atrial or ventricular systole. Systolic sounds occurring in tricuspid insufficiency may be termed “venous pistol shot sounds” and should be differentiated from the more frequently encountered pistol shot sounds of arterial origin.
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