"Polyphonic" heart sounds

"Multi-tonal" heart sounds are the main clinical manifestations of Ebstein syndrome. Ebstein syndrome, also known as Ebstein's malformation, refers to the tricuspid septum and / or posterior valve occasionally attached to the proximal apex with the anterior valve down The right ventricular wall accounts for about 0.5% to 1.0% of congenital heart disease. This disease is a rare disease, first reported by Ebstein in 1866. This disease is also called tricuspid valve malformation. The main signs of Ebstein syndrome include: a bulging and quiet precardiac area (no obvious precardiac pulsation at palpation, no sense of pulmonary artery closure on palpation); the first heart sound and the second heart sound are clearly divided and may have enhanced The third heart sound can also appear the fourth heart sound; the second component of the divided first heart sound is often a karaoke. This is the so-called "sail sign"; the tricuspid area can appear soft systolic murmurs and short There are also cyanosis in the middle diastolic murmur. The positive pulsation of the jugular systole in the clubbing finger (toe). Siber believes that the most characteristic signs for this deformity are these two groups: ① cyanosis with a quiet precardiac region; Quartet consisting of the first heart sound, the split second heart sound, the enhanced third heart sound, or the fourth heart sound