17 July 2020
: Case report 
“The Heart Sound Quintet”: A Case Report of Right-Sided Heart Failure Due to Free Pulmonary Regurgitation Long After Intracardiac Repair of Tetralogy of Fallot
Challenging differential diagnosis, Unusual setting of medical care, Patient complains / malpractice, Congenital defects / diseases, Educational Purpose (only if useful for a systematic review or synthesis)
Hiroshi Fujita1EF, Kensuke Matsumoto1ABCDEF*, Keisuke Miwa1BD, Makiko Suzuki1BD, Makiko Suto1BD, Jun Sakai1B, Hidekazu Tanaka1E, Ken-ichi Hirata1DGDOI: 10.12659/AJCR.924636
Am J Case Rep 2020; 21:e924636
Figure 5. Simultaneous presentation of the electrocardiogram, phonocardiogram, and pressure waveforms from the right atrium, right ventricle, and pulmonary artery. The phonocardiogram clearly shows the widely split S1, single S2, and right-sided S3 and S4. Note that S4 and S3 are coincident with a prominent a wave and deep y descent in the right atrial pressure waveform, respectively. Pulmonary arterial and right ventricular end-diastolic pressures are almost identical due to free PR. ECG – electrocardiogram; RA – right atrial; RV – right ventricle; PA – pulmonary artery.