JOSEPH M. MAUCERI, M.D.
To the Editor: The Question of the Month (700) on cardiovascular diseases in the April ANNALS included the statement that direct arterial measurements of diastolic blood pressure were best correlated with changes in auscultatory sound rather than the final sound heard. This was considered incorrect vis à vis the answer given. It is a well-known clinical observation that in patients with high output states and low diastolic pressures the diastolic reading between the third and fourth auscultatory phases—that is, that point where Korotkoff sounds change from a soft thud to a softer blowing quality, "muffling"—more accurately reflects intra-arterial diastolic levels.
MAUCERI JM. QUESTION OF THE MONTH. Ann Intern Med. ;71:216. doi: 10.7326/0003-4819-71-1-216
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Published: Ann Intern Med. 1969;71(1):216.
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