Physical Diagnosis

Cover Physical Diagnosis
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The " tick-tack " rhythm may be heard in any form of cardiac disease after compensation has failed, or in any condition leading to collapse.
(2) A less common change of rhythm is that produced by a shortening of the interval between the two heart sounds owing to an incompleteness of the contraction of the ventricle. This change may occur in any disease of the heart when compensation fails.
(3) The " Ga^oj;, Rhythm. " Shortening of the diastolic pause together with doubling of one or another of
...the cardiac sounds re- sults in our hearing at the apex of the heart three sounds instead of two, which follow each other in a rhythm suggesting the hoof beats of a galloping horse. Such a rhythm may occur temporarily in any heart which is excited or overworked from any cause, but when permanent is usually a sign of grave cardiac- weakness. The rhythms so produced are usually anapaestic, ^ ^ ', ^ ^ ', ^->^ ', or of this type : ^ ' ^, ^ ' -^, ^ ^.
Doubling of the Second Sounds at the Base of the Heart.


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