. The heart and the aorta; studies in clinical radiology . umes its normal caliber. On the right itprojects over the sternum, and at this point (at the levelof the arrow) the aortic shadow shows very ample pul-sations. In the right anterior oblique position (Fig, 75), theaortic shadow assumes the form of a cone, the largestpart of which corresponds to the base of the heart. The conclusion from the examination of these twofigures is that there was aortic insufficiency, as ausculta-tion indicated, but that this lesion was, so to speak, onlyan epiphenomenon occurring in the course of aortitis. In
. The heart and the aorta; studies in clinical radiology . umes its normal caliber. On the right itprojects over the sternum, and at this point (at the levelof the arrow) the aortic shadow shows very ample pul-sations. In the right anterior oblique position (Fig, 75), theaortic shadow assumes the form of a cone, the largestpart of which corresponds to the base of the heart. The conclusion from the examination of these twofigures is that there was aortic insufficiency, as ausculta-tion indicated, but that this lesion was, so to speak, onlyan epiphenomenon occurring in the course of aortitis. In the following case (Fig. 76), the clinical and radio- 110 THE HEART AND THE AORTA scopic signs were still more emphasized. A man thirty-nine years of age with Hodgsons disease, presentingserious functional disturbances: dyspnoea on exertion,vertigo and anginose attacks. The tracing shows in thefrontal position a considerable enlargement of the areaof projection of the heart. The longitudinal diametermeasures 16 cm., the horizontal, cm.; the apex is. Fig. 76. AOETIC INSUFFICIENCY OF ARTERIAL ORIGIN. MAN39 YEARS OF AGE rounded and lowered. In the right posterior obliqueposition it disappears behind the vertebral column onlyat an angle of 48 degrees. On the screen the left contourof the heart, greatly enlarged, showed ample pulsations;the ascending portion of the aorta was dilated, tortuous,dense, and at each systole the arch as a whole showedforcible pulsation. There were found characteristics of both lesions:aortitis and valvular insufficiency. But these lesions wereaccompanied, besides, by an interesting in cases of simple aortitis the vascular contour VALVULAR AFFECTIONS 111 is muck reduced in its rhythmic expansion, because ofthe thickening of the arterial walls, here, on the contrary,the arch was animated at each systole by forcible pulsa-tions. The forcible contraction of the left ventricle dis-placed the arch entirely, and these displacements were
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