. The heart and the aorta; studies in clinical radiology . rence confirms the radiological diag-nosis, which is a transverse enlargement of the heart dueto the development of the right cavities. VALVULAR AFFECTIONS 89 In the right posterior oblique position, moreover, theapex of the heart disappeared behind the shadow of thevertebral column only at an angle of 42 degrees insteadof at 25 to 30, the normal figure. That could be explainedonly by a ventricular enlargement in which the left ven-tricle was involved to a certain extent but less than theright. Finally, in the oblique position the left
. The heart and the aorta; studies in clinical radiology . rence confirms the radiological diag-nosis, which is a transverse enlargement of the heart dueto the development of the right cavities. VALVULAR AFFECTIONS 89 In the right posterior oblique position, moreover, theapex of the heart disappeared behind the shadow of thevertebral column only at an angle of 42 degrees insteadof at 25 to 30, the normal figure. That could be explainedonly by a ventricular enlargement in which the left ven-tricle was involved to a certain extent but less than theright. Finally, in the oblique position the left auricle did notappear to be changed. These signs agree with the pathological findings whichshow that in mitral insufficiency a slight hypertrophy ofthe left ventricle exists, an insignificant enlargement ofthe right ventricle which varies with the severity of thesymptoms. It is not surprising, therefore, that the ven-tricles are accentuated when mitral insufficiency is com-plicated with dyspnoea, cyanosis, oedema of the extremi-ties, etc. (See Fig. 55.). Fig. 55. MITEAL INSUFFICIENCY. MAEKED ENLAEGEMENT OFTHE EIGHT HEAET. MAN 34 YEAES OF AGE This shows that the heart is greatly enlarged and thatthe enlargement is of the two ventricles, principally theright. On the left, the ventricle bulges, its contour is 90 THE HEART AND THE AORTA elongated, its apex pushed out but not lowered and on theother side the salience of the shadow corresponds to thelower part of the contour or to the region of the rightventricle, and further evidence is the presence at thispoint of systolic pulsations. The two diameters measure:horizontal, cm.; longitudinal, cm., instead of , then, have increased, especially the horizontal,which denotes a generalized hypertrophy, but predomi-nant on the right.
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