Aortic Valvular Disease Research Articles

Electrocardiographic abnormalities characteristic of certain cases of arterial hypertension

It has been shown that electrocardiograms which exhibit the multiple abnormalities described differ from electrocardiograms of the T 1 type of coronary thrombosis. However, 16 of the 143 patients whose cases were reviewed had coronary thrombosis. In all 16 cases electrocardiograms showed the type of abnormality here recorded, and in none was the changing electrocardiographic picture of myocardial infarction found. Since 14 of these 16 patients had hypertension, the possibility must be kept in mind that antecedent or existing hypertension was the factor responsible for these abnormalities rather than cardiac infarction. It has been found that arterial hypertension was present in 124 of the 143 patients and that 11 of the remaining 19 patients had aortic valvular disease; from the evidence available preexistent hypertension was probable in at least 5 of the other 8 cases. Thus, in these cases there was present one or other of the two most important factors which determine hypertrophy of the left ventricle. In addition, it was found that left ventricular hypertrophy was present in all cases examined post mortem. It would seem justifiable, therefore, to conclude that these distinctive electrocardiographic abnormalities were characteristic of certain cases of left ventricular hypertrophy and, since arterial hypertension was by far the most frequent determining cause of that hypertrophy, that these electrocardiographic changes were practically diagnostic of hypertension. Further investigation regarding the relationship of these electrocardiographic abnormalities to left ventricular hypertrophy and to hypertension is in progress and will be reported upon later. ∗ ∗ Just before this paper was submitted for publication, a single record of similar electrocardiographic abnormality obtained from a patient with essential hypertension was published by the late Joseph H. Bainton and Julius Burstein, “Illustrative Electrocardiography,” New York, 1935, D. Appleton-Century Company.

CALCAREOUS AORTIC VALVULAR LESIONS

Article1 October 1933CALCAREOUS AORTIC VALVULAR LESIONSBURR M. HATHAWAY, A.B., M.D.BURR M. HATHAWAY, A.B., M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-7-4-484 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptStenosis of the aortic valve, with calcification, continues to attract the attention of clinicians and pathologists. The frequency with which this condition is found at autopsy, in contrast to the infrequency of its clinical diagnosis, and the unsettled state of opinion as to its etiology invite further study. To this end, 52 examples of aortic valvular disease have been selected from 4000 consecutive autopsies; these have been divided into significant groups, and subjected to clinico-pathological analysis. The results of this statistical study justify certain conclusions as to the etiology of this form of cardiac disease.SURVEY OF LITERATUREAortic stenosis...

The relationship of angina pectoris to aortic valvular disease

The relationship of angina pectoris to aortic valvular disease

The Roentgenologic Differentiation of Lesions of the Right and Left Heart

IN the development of the roentgen examination of the heart, the accurate determination of the size of the organ has been chiefly considered. The differentiation of the normal from the abnormal heart by the increase in transverse diameter, surface area, or volume, as demonstrated in the teleoroentgenogram, or orthodiagram, has been well established. Much less attention has been given to the increases in size, which may take place in individual chambers. While changes in the shape of the heart shadow have been widely used to determine the exact nature of the defect which is present, these have been chiefly studied in the postero-anterior projection. Lateral views which might demonstrate enlargement of the posterior chambers of the heart, the left atrium, and left ventricle, have been less emphasized, chiefly, no doubt, because of the difficulty in interpretation. Cardiac disease, with or without failure, may, for certain purposes, be classified in two broad groups: left heart lesions and right heart lesions. The former are by far the more numerous and include essentially the defects of the valves of the left heart, the aortic and mitral, and the cardiac enlargements which result from increased blood pressure. With a few rare exceptions, the diseases of the left heart are acquired lesions. It is true that mitral valvular disease affects the right heart early in its career, but the lesion originates on the left side and is properly classified as such. Right heart lesions are less common and more heterogeneous. They include disease of the pulmonic and tricuspid valves, either congenital or acquired, other congenital defects, and right heart enlargements from diseases of the lungs or of the pulmonary vessels. Such pulmonary conditions as pneumonoconiosis, asthma, emphysema, and chronic lung fibrosis may produce sufficient obstruction in the pulmonary circulation to cause hypertrophy and dilatation of the right ventricle and right auricle, with eventual right heart failure. Likewise, primary disease of the pulmonary vessels, sclerosis, and, possibly, hypertension may eventuate in the same situation. It is a common feature of all these diseases that the enlargement is confined to the right side of the heart, the left being rarely, if ever, affected, even late in the disease. Ordinarily, the distinction between those lesions which primarily affect the left ventricle, such as aortic valvular disease and hypertension, and diseases of the right heart is comparatively simple, both clinically and roentgenologically. The physical findings and the postero-anterior roentgenograms are very different in the two cases. In mitral disease, however, this differentiation is often difficult. That this is true can be borne out by anyone who has examined many cases of cardiac disease in children, in whom congenital defects are so common.

A note on aortic valvular disease: Campbell, Maurice, and Shackle, J. W.: Brit. M. J. 1: 328, 1932

A note on aortic valvular disease: Campbell, Maurice, and Shackle, J. W.: Brit. M. J. 1: 328, 1932

A NOTE ON AORTIC VALVULAR DISEASE: WITH REFERENCE TO ETIOLOGY AND PROGNOSIS

A NOTE ON AORTIC VALVULAR DISEASE: WITH REFERENCE TO ETIOLOGY AND PROGNOSIS

Emergencies of General Practice.

The term cardiac asthma is applicable to a clinical syndrome-paroxysmal dyspnoea due to heart failure -with a range of severity extending from urgent acute pulmonary oedema to transient nightly attacks of cough, wheezing, and breathlessness, though used by some to refer only to the latter. Although such paroxysms some times occur in the presence of mitral stenosis, they are most commonly an expression of left ventricular failure in hypertensive, coronary, or aortic valvular disease. A sudden attack of intense dyspnoea is not infrequently caused by acute myocardial infarction, and the occa sional absence of the characteristic pain or the over shadowing of pain by the intense dyspnoea may result in the basic lesion being missed.

The Treatment of Aortic Valvular Disease

The Treatment of Aortic Valvular Disease

Cases with Mental Symptoms following the Administration of Chloral Hydrate

Case I.—Mrs. A., ót. 55, married. Admitted into the Infirmary 14th April, 1875, suffering from aortic valvular disease, with sequelae. Ordered iron, digitalis, and gin, generous diet, and an unstinted supply of fresh milk. On account of the sleeplessness and restlessness, on the 30th April, there was prescribed for her 15 grs. of choral hydrate, to be taken at bedtime. A week afterwards this was doubled. About the middle of May she was observed to be getting decidedly “strange;” the mental aberration gradually increased, and towards the end of the month culminated in subacute mania, with hallucinations and illusions of sight. No improvement took place in the physical symptoms.