Medicine: Booming Hearts

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William Bennett Bean, a young resident physician at Cincinnati General Hospital, was alarmed by a patient who complained that his heart was making a noise "like a paddle wheel on a river." Dr. Bean could hear the noise clearly at a distance of two feet; through the stethoscope it was so loud that it hurt his ears. The patient recovered without any special treatment. But the experience made Dr. Bean a student of booming hearts.

In 14 years of research, he tracked down 164 cases, reports Dr. Bean (now at the University of Iowa) in the current A.M.A. Journal. The cases range over 300 years, from a "woeman or mayd in Suffolk who had a julking and fluctuation in her chest . . . heard by the standers by," to soldiers in modern war. Some of the noises—likened to the grinding of gears, the rustling of leaves, the crunching of newspapers, the cooing of doves—have kept their victims awake for nights on end; others have made it impossible for husbands or wives to sleep in the same room. The record distance at which such sounds could be heard: 20 feet.

Many of the cases are relatively harmless, but some patients need quick treatment to save their lives. The cause, according to Dr. Bean: in almost one third of the cases, a heart valve is functioning faultily; in most of the others, air gets into the heart or nearby tissues where it does not belong and acts as a sound chamber. Treatment may range from reassuring the patient to drawing off the air from the churning heart.