. The American journal of roentgenology, radium therapy and nuclear medicine . SEASES INVOLVING THE GREAT VESSELS This subject was more fully covered in aprevious article^\ but this survey of diseasesof the heart would hardly be complete with-out some reference to it. Many of the draw-ings shown here were used in the previousarticle. It is probably true that a large num-ber of cardiac cases are sent to the roentgen-ologist because the clinician is afraid thathe may be overlooking a syphilitic aortitisor to check up his diagnosis of that condi-tion. The diagnosis of aortitis should bemade with


. The American journal of roentgenology, radium therapy and nuclear medicine . SEASES INVOLVING THE GREAT VESSELS This subject was more fully covered in aprevious article^\ but this survey of diseasesof the heart would hardly be complete with-out some reference to it. Many of the draw-ings shown here were used in the previousarticle. It is probably true that a large num-ber of cardiac cases are sent to the roentgen-ologist because the clinician is afraid thathe may be overlooking a syphilitic aortitisor to check up his diagnosis of that condi-tion. The diagnosis of aortitis should bemade with the greatest caution in casesshowing widened shadows of the great ves-sels. Arteriosclerosis, hypertension, chronicmitral disease, a high diaphragm, or an en-larged pulmonary artery may produce wid-ened shadows of the great vessels. Figure 19 illustrates a typical wide, tor-tuous aortic arch of the type seen in ad-vanced arteriosclerosis. The widening isapparently due to the fact that the descend-ing aorta swings to the left. The aortic knob 3o6 Roentgen Ray Cardiac Studies. Fig. 12. Mitral Disease and Chorea. O. P. D. 13, 1914. P. H. Negative except for scarletfever five months previously. P. I. Has complained of tenderness on beingtouched for several weeks. Is very nervous andrather weak. P. E. Patient is a white girl seven years of are ragged and protrude. Heart is is not enlarged. Sounds regular and of goodquality. Xo murmurs heard. No swollen or tenderjoints. Considerable choreiform movement. Mar. 20, 1920. P. E. Heaving apex impulse inthe 5th §pace 10 cm. to the left of the systolic murmur at the apex partly maskingthe 1st sound. Pulmonic 2nd sound very loud andreduplicated at the apex. Slight diastolic rumblewhen the patient lies down. is usually prominent in arch sclerosis eventhough it be partially obliterated by theshadow of the descending portion of thevessel. If the patient be rotated to the leftin the fluorosco


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