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The diminished second sound in such patients is now recognized to reflect isovolumic relaxation, and the diminished first sound probably reflects impaired isovolumic contraction. Ejection murmurs can be interpreted in light of their relation to turbulent flow. The variability of regur gitant murmurs in the papillary muscle dysfunction syndrome seems to be explained by new observations related to the function of the papillary muscle.<\/jats:p>","DOI":"10.1177\/000331978203300606","type":"journal-article","created":{"date-parts":[[2007,11,26]],"date-time":"2007-11-26T17:46:29Z","timestamp":1196099189000},"page":"401-409","source":"Crossref","is-referenced-by-count":0,"title":["What Is New In The Clinical Evaluation of Patients With Ischemic Heart Disease?"],"prefix":"10.1177","volume":"33","author":[{"given":"Paul D.","family":"Stein","sequence":"first","affiliation":[{"name":"Cardiovascular Division, Department of Medicine, Henry Ford Hospital, Detroit, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[1982,6,1]]},"reference":[{"key":"atypb1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.30.6.835"},{"key":"atypb2","unstructured":"Fowler NO: Cardiac Diagnosis of Heart Disease. 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