STUDY OF THE POTASSIUM METABOLISM AND THE SECOND HEART SOUND IN ACUTE GLOMERULONEPHRITIS:PART 2. THE SECOND HEART SOUND IN HYPERPOTASSEMIA IN THE COURSE OF ACUTE GLOMERULONEPHRITIS. PART 3. THE SECOND HEART SOUND IN HYPERPOTASSEMIA INDUCED BY ORAL ADMINIS

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Twenty cases of acute glomerulonephritis that recovered in two to three months are reported. Hyperpotassemia was noted in the later stage of the disease in eleven cases. Phonocardiographic studies were done repeatedly during the course of the acute glomerulonephritis along with electrocardiographic and electrolyte studies of the serum and clinical observation.The second heart sound commonly begins almost simultaneously with the end of the T wave of E. C. G. within a range of 0.035 second before the end of the T wave and 0.02 second after the end of the T wave.In cases of acute nephritis when serum potassium was elevated, the second heart sound began earlier than 0.035 second before the end of the T wave. No relationship was observed between the onset of the secound heart sound and change of blood pressure or pulse rate. In most of the cases mentioned above the Q-T interval was within normal limits.Hyperpotassemia was induced with oral administration of potassium chloride in five healthy persons and in five persons who had recovered from nephritis, but there was no change in the time relationship of the occurrence of the second heart sound with the end of the T of the E. C. G.The author considers that an important factor causing discrepancy between mechanical and electrical systole may be disturbed metabolism of potassium which appeared temporarily in the course of acute glomerulonephritis.
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