Intermezzo – What is onomatopoeia of Our Heart beat sounds like?

What is onomatopoeia of Our Heart beat sounds like?


 Department of Internal Medicine at Waled Hospital Cirebon, West Java, Indonesia.



What is onomatopoeia of our heart sound?

The sound is a longitudinal wave, the result of a vibration that stimulates the senses of hearing1. To know what sound is, or to know where the source of the sound comes from, is the task of the auditory perception center in the temporal lobes of the brain2. From vibration of sound which is catch by ear to auditory canal tympanic membrane to Malleus to incus and stapes, stir up oval window and cochlea fluid and then auditory nerve endings which sends impuls to brain’s auditory perception in temporal lobe. Normal people would know where the source of the noise up to the level of perception. But what exactly is the right sound that produced by the sound source? It’s highly subjective. It depends on the culture or habits of groups / people / the nation. Onomatopoeia refers to a word or group of words that imitate the sound from the source of sound3. For example, the sound of gunshots were heard dor – dor in Indonesia, but bang-bang in the US / UK, paw-paw in the Netherlands4. The sound of rooster’s crowed in Indonesia is kukuruyuk, British is cock a doodle do, in Germany kickeriki, in Iceland gagala-gagala and in Chinese (Mandarin) gou-gou5.

So is the sound of the heart. In that literature we are forced to say that the sound of the heart is lub-dup. But there are many countries do not declare lub-dup as the sound of the heart. Here is an example of the various states of onomatopoeia regarding the hearth beat sound (1stHearth Sound-2nd Hearth Sound)5.

Name Of Country Onomatopoeia
Indonesian deg-degan, dag-dig-dug, dug-tek
English lub-dup, thump-thump
China (Mandarin) peng-peng
France bom-bom, poum-poum
Germany poch-poch
Japan do-ki
Canada da-va
Arab ratama-ratama
Thailand tup-tup
Turky gum-gum
Tamil lappu-lappu
Sweden du-dunk
Rusian tuc-tuc
Persia tap-tap
Norwegia dunk-dunk

From the example above, the verbal of heart beat sound or onomatopoeia in the world can be vary. Is it possible to generalized the heart beat onomatopoeia? Which verbal or actual heart beat sound is the most appropriate? The closest verbal sound to mechanism of physics or physiology of the heart beat sound, is the most appropriate. I proposehuallah (with perfect Arabic spelling) as verbal or onomatopoeia of the heart sound. When verbalhuallah – (in perfect Arabic spelling) written in Latin, then the writing is Alloo-Hu or spoken “Allooh”6. Onomatopoeia Alloo-Hu is the closest to physical or physiological mechanisms of heart sounds.

The sound is basically made up of two major components, namely, amplitude and frequency. Amplitude is a deviation that affect the strength of the sound, which is derived from a vibration.7 While the frequency is the number of vibrations that occur in one second8.

Noise or heart beat sound, caused by vibrations of muscular wall of the heart and blood vessels due to the closure of the heart valves9. There are four valves in the heart, the mitral valve, tricuspid, pulmonary and aortic valves. Mitral valve is a valve that is located between ventricle / left ventricle and atrium / left atrium. Tricuspid valve is a valve that form the boundary between the right ventricle and the right atrium. Both are called atrioventricular valve or AV valve. The aortic valve is the valve that lies between aorta and left ventricle. Pulmonary valve is the valve that lies between pulmonary artery and right ventricle. Both valves are called semilunare valve. Atrioventricular valve is thicker than semilunare valve. Heart beat were made basically by two kinds of sounds, the first heart sounds (1stHS) and the second heart sound (2ndHS). First heart sound is the sound or voice that heard when atrioventricular valve (mitral and trikuspid) closes and blood comes out from the left ventricle of the heart into aorta and then to the rest of the body, and from the right ventricle to the lungs. Discharge of blood from the heart caused by opening of both semilunare valves, when the AV valves closed. While the second heart sound is sound or voice that heard when both semilunare valves (aortic and pulmonary) are closed and blood from the body flow into the right atrium and then into the right ventricle and blood from the lungs into the left atrium and then into the left ventricle. The blood flows into the ventricles because both AV valves are open when both semilunare valve close.

With the description above, it can be understood that the first heart sound will be heard heavier at the start, harder and longer than the second heart sound of the heart9. Heavier and harder in the beginning, because of shock wave vibrations of the large blood vessels and walls induced by the setting of thick AV valve. Amplitude that occurs from 1stHS is greater than 2ndHS. Nevertheless, the rapid vibrations would decrease its power. AV valve thickness effect also causes longer and harder opening and closing of the AV valves than the semilunare valve. Thus physiological state, indicated by the length of time in cardiac filling (diastolic ventricular) is longer than the discharge of blood from the heart (ventricular systolic)9,10. The proportion is 65%: 35% 10.

Anatomical structure differential of the AV valves and semilunare valves will also lead to a lower frequency audible of 1stHS (more subtle). The second heart sounds will be heard weaker, but with higher frequencies (voice sounded sharper) and shorter in time9. Seminulare valves thinness is the cause of the higher frequency or sharper than 1stHS.



Conclusions from the descriptions above is the word of allah-full (with a perfect Arabic spelling) may describe 1stHS and 2ndHS. In detail is Alloo (1stHS) – Hu (2ndHS) with a perfect spelling of the Arabic language. (huallah).

The imperfect spelling of huallah (according to perfect Arabic spelling), mean the occurrence of disease in these individuals or not in accordance with the physical mechanism of heart sound (1stHS and 2ndHS). For example, when we say that onomatopoeia of 1stHS-2ndHS is Aw (1stHS) – loh (2ndHS) or A (1stHS) – lah (2ndHS). It means weakness in the ventricular muscle or the heart valves. Same with the All-Looh. All (1stHS) does not indicate a longer time than 2ndHS (Looh). While Looh (2ndHS), does not show a sharp frequency. Much less sharp, when compared to 2ndHS that voiced with Hu.

On the other hand has been known, that the filling of blood into the heart takes one tenth of a second longer (semilunare valve has been closed while the AV valve is still open). So at that time there was no sound whatsoever (silent). So the actual heart sounds are Dug – Tek – Silent, Dug – Tek – Silent. Or lub – Dup – Silent, Lub – Dup – Silent11. Or huallah– Sillent,  huallah Sillent. But within one tenth of a second is very short, so that sound is 1stHS-2ndHS, uninterruptible. This is consistent with what is written above about the time length of ventricular filling (diastolic) is longer than the time length of blood discharge from the ventricle (systolic). Thus the AV valves open longer than semilunare valves. Or the closing length of the AV valves are faster than semilunare valves. This does not mean that 1stHS is faster than 2ndHS. Because the heart sound as previously explained is the length of the vibrations of the blood vessels and the ventricular wall due to the closing of heart valves. So 1stHS remains longer autibly than 2ndHS.


P: no sound

Heart beat sound frequency should not be too slow or too fast (generally 60-100x per minute). With the information above, we see that the heart actually moves very regularly in the name of perfect huallahcompletely or huallah– Silent, huallah-Silent, huallah– Silent. Or if written in Latin Alloo-Hu-Silent, Alloo-Hu-Silent, Alloo-Hu-Silent.

Where this idea was taken? I took this idea from the the Qur’an which is recognized as the Muslim’s holy book.

Surah An-Nahl 48: “Have they not considered what things Allooh has created? There shadows incline to the right and to the left, prostrating to Allooh, while they are humble”12,

Ibn Kasir who wrote the interpretation of the Koran and his writing become reference to Muslims around the world, interpreted the verses that all beings were created by Allah and has shadow, the shadow is always bowing to Allah and humbled himself. While return back and forth right and left, meaning the state of the shadow in the morning and afternoon of the day13. Likewise, the books of other great commentators like Jalalain, At-Tabari Interpretation, much less interprete the verse An-Nahl 48, like what was written by Ibn Katsir14.

If we can prove that the object is actually and significantly in a prostrate (obeisance) position (not imagining), actually moves left or right in real and humble itself for real, then this interpretation would be stronger than the interpretation of Ibn Kasir et al. And when the heart can be proved as the object in question, then the name of the God of Islam, is the onomatopoeia of the sound of the human heartbeat. Because humility can also be interpreted to invoke the name of God continuously without a break.

Is the human heart in a prostrate position?

The heart is a hollow, muscular organ about the size of a fist. This organ is located between the chest / thoracic spine adjacent to the front and the back / rear side of the thoracic vertebrae. The heart has widened over the base and tapers down to form a point at the bottom edge, called the apex. So when the heart shape viewed from the left / right / up then the heart will be seen in a state of prostration. Prostrate position of the heart will be clear when the man in a state of lying on his back facing up and we see the heart of the person from above. Thus prostrate criteria has been fulfilled by the heart.

Is that true that our heart moves to the right and left?

When the heart beats strong, apex located at the bottom of the heart which is actually a part of the left ventricle / left ventricel, move forward and we can touch on the left chest. This we call ictus cordis (heart beat is palpable on the left chest). The actual end of the right ventricle was moving backward when the heart throbbing hard or when the contraction pump blood to the lungs. But the movement of the right ventricle can not be in touch because it was blocked by the muscles and spine. So that when the apex (tip of the left ventricle) moves toward the chest / front and right ventricular tip moves toward the rear as well as the return of the two ends of the ventricle to its original position, we will see from the left on the heart, the heart is moving to the right and left. With such visual imagination, the “shadow that moves back and forth right and left”criteria has been filled by the heart. (See “bagaimana jantung bekerja”). Allah called right first because the heart movement forward is more free due to the absence of resistance and stronger movement of left ventricular. Thus the criteria for heart moving right and left back and forth has been filled, as well as his shadow.

Then, is the heart qualify for the criteria of humility?

The actual position of the heart is like that and should continuosly be in that position or should not be enlarged or shrunk and must bow down as it beats continuously throughout the life of a human being, showed a humble attitude and even a low self-esteem. But humility could also be interpreted when an object or heart continuously mentions the name of his Lord. Name of God according to the Quran is huallah (with perfect Arabic spelling). On that basis, I proposed the idea that the heart beat sound onomatopoeia is Alloo-Hu.

An Nahl: 49

“And to Allooh prostrates whatever is in the heaven and whatever is on the earth of creatures, and the angels (as well), and they are not arrogant.”12

Ar Rad: 15

“And to Allooh prostrates whoever is withing the heavens and the earth, willingly or by compulsion, and there shadows (as well), in the morning and the afternoons.”12

Prostrates that said in an Nahl: 49 and ar Rad: 15, does not show that these objects were really in a state of prostration. But the intent faces in that paragraph indicates that these objects must follow the law of nature or the law that apply to these objects (if the object is to survive or healthy). If the object comply to the laws of nature that apply to him/it, then it is definitely his/it’s shadow or any derivative of these objects must prostrate or obedient too.


It has been explained about the appropriate verbal of Alloo-Hu to show 1stHS and 2ndHS (onomatopoeia). Although the author does not have the ability to utter verbal heart sounds well from various verbal heart beat sound or onomatopoeia of all nations in this world, but in general the author believes that verbal of the nations in the world to signify the 1stHS – 2ndHS, is not appropriate for physics or physiology mechanism of 1stHS – 2ndHS. Nevertheless other may propose another onomatopoeia from what the authors propose. In accordance with the mechanism of the physics and physiology of the heart beat sound. Maria Florencia et al, proposed to use machine / computer that is able to describe the sound spectrum to obtain the right onomatopoeia.14 If that happens, then still, Alloo-Hu as onomatopoeia of heart beat soundscan not be ruled out, if we can not refuse this paper. If this is recognized, the entire people of the world have to learn to say verbal Alloo-Hu properly and correctly (in accordance to perfect Arabic spelling). Or lub-dup sound that illustrates heart beat sound can be replaced with Alloo-Hu.

The latest proposal is to replace the word Allah with Allooh, to habituate the proper pronouncation of His name.


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