. Medical diagnosis for the student and practitioner. Fig. 346.—(E 77). Same heart as shown in Fig. 345 showing the reduced diameterfollowing a short period of ambulatory treatment. The heart was originally a drop heart,marked associated gastroptosis being present. The outer white line shows the passing outof the left border by renewed dilatations after the patient had broken treatment anddisregarded all instructions, the result being the recurrence of pulmonary congestion andother signs of minor decompensation. shows a tendency to involve the other regions in part at least. Carefulexamination
. Medical diagnosis for the student and practitioner. Fig. 346.—(E 77). Same heart as shown in Fig. 345 showing the reduced diameterfollowing a short period of ambulatory treatment. The heart was originally a drop heart,marked associated gastroptosis being present. The outer white line shows the passing outof the left border by renewed dilatations after the patient had broken treatment anddisregarded all instructions, the result being the recurrence of pulmonary congestion andother signs of minor decompensation. shows a tendency to involve the other regions in part at least. Carefulexamination of the heart, and blood-pressure estimations, usually reveal anadequate cause. A Word of Warning.—It must be remembered that gastric, duodenal, H1AK r DECOMPENS \ HON 645. Fig. 347.—Toxic heart. Patient had suffered from gall-stones 10 years previously andtemporary relief had been afforded by the passage of a large number of small biliary to, and from that time, recurrent severe precordial and epigastric pain and increas-ing disability had been present, all being charged against the gall bladder, though no opera-tion was attempted. When seen by the author in 1914 she carried decided edema of thelegs, some hepatic engorgement, and marked enlargement of the heart, with auricular fibril-lation. A history of recurrent typical attacks of cardiac angina combined with epigastricdistress was obtained and the nature of some of the abdominal pain distinctly suggestedthe participation of the diseased gall-bladder, although no local tenderness or fever waspresent. The heart measured cm. in total transverse diameter a-nd decided diffuseenlargement of the transverse and descending portion of the aortic arch was evident in theoriginal negative.
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1922
