The Use of Methoxamine as a Diagnostic Aid in Clinical Phonocardiography

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Functional phonocardiography using methoxamine was performed in 400 cases of various cardiovascular diseases including normal subjects.Intravenous administration of methoxamine (0.08 to 0.1mg./Kg. within 20 to 30sec.) caused the rise in systemic arterial pressure in an average of 45% and the subsequent bradycardia. During the maximum effect (1 to 3min. from the start of the injection), the heart sounds are affected significantly and the heart murmurs changed in the following fashion.The left-sided regurgitant murmurs were intensified, whereas the rightsided ones were not affected significantly or decreased except the increase in the pulmonic regurgitant murmur in Eisenmenger syndrome. The ejection systolic murmurs were changed insignificantly or slightly decreased except the case of tetralogy of Fallot. The pulmonic systolic murmur of atrial septal defect may be intensified. The ventricular filling as well as the atriosystolic murmurs of organic mitral stenosis decreased, whereas the murmur of relative mitral stenosis increased.In some cases, atypical murmur changed into typical configuration, and the silent or latent state of left-sided valve lesion was disclosed in many cases.Discussions were made on the mechanism of the above-mentioned effect and the usefulness as well as the limitation of this functional test.
International Heart Journal刊行会の論文