. The heart and the aorta; studies in clinical radiology . the hospital in 1908and in January, 1910, for suffocating attacks of an oedem-atous nature. In March, 1910, he entered our depart-ment, with a similar attack which yielded to a copiousphlebotomy. Examination showed that the heart wasenlarged and dilated, and that at the apex there was,together with a very clear purring thrill, a somewhatmodified systolic murmur, superficial, rather rough andlying below and within the heart apex. Arterial pressurewas 15 cm. by sphygmometer. The urine contained aconsiderable quantity of albumen. The logi
. The heart and the aorta; studies in clinical radiology . the hospital in 1908and in January, 1910, for suffocating attacks of an oedem-atous nature. In March, 1910, he entered our depart-ment, with a similar attack which yielded to a copiousphlebotomy. Examination showed that the heart wasenlarged and dilated, and that at the apex there was,together with a very clear purring thrill, a somewhatmodified systolic murmur, superficial, rather rough andlying below and within the heart apex. Arterial pressurewas 15 cm. by sphygmometer. The urine contained aconsiderable quantity of albumen. The logical diagnosis from these findings should be asfollows: mitral insufficiency with beginning cardiac insuf-ficiency. The principal points of the case, notably thepulmonary cedematous attacks and the absence of periph-eral oedema, are not explained. Finally, no history ofinfectious disease was found which could have given riseto mitral endocarditis. 94 THE HEART AND THE AORTA Radioscopic examination gave, on the other hand, vain-able information (Fig. 58).. Fig. 58. FUNCTIONAL MITEAL AGE MAN 46 YEAES It enabled recognition at once of the ordinary signs ofmitral insufficiency: apex slightly lowered bnt pushedoutward, with enlargement of the right ventricle; itshowed, moreover, certain anomalies. The contour of theleft ventricle was more marked than in cases of endocar-ditic mitral insufficiency; the apex, instead of beingpointed, was rounded, slightly globulous. Finally, thelongitudinal diameter measured cm., while the hori-zontal was only cm., so that there was a difference infavor of the longitudinal diameter contrary to what wehave indicated in the In conclusion, in estimating the total increase in thevolume of the heart, hypertrophy of the left ventricleplayed a much greater part than in the case of simplemitral insufficiency. The impression derived from clinical examination, is In analogous cases the figure of the index of depth is singu
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