Some expansion of these remarks concerning the heart sound changes in coronary thrombosis may enhance their diag- nostic value for the general practitioner. If the first heart sound is suddenly observed to have become faint and muffled and the second relatively loud in an individual previously known to possess a normal intensity of his first and second heart sounds, then these altered heart sound findings are highly significant of a sudden impairment of the contractility of the heart, i.e., of an acute heart failure, such as coronary thrombosis.
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