. The heart and the aorta; studies in clinical radiology . Fig. 68. AOETIC INSUFFICIENCY. PEEIOD OF 40 YEAES OF AGE 104 THE HEART AND THE AORTA Finally—and this agrees with the preceding data—thelongitudinal diameter exceeds the normal, and the hori-zontal diameter is decidedly less. In the right posterior oblique position (Fig. 69), theapex of the heart disappears behind the vertebral columnonly at a wide angle, a fact which is easily explained, ifit is granted, as has been shown, that hypertrophy of theleft ventricle in its early stage affects the mediastinalarea. Sometimes
. The heart and the aorta; studies in clinical radiology . Fig. 68. AOETIC INSUFFICIENCY. PEEIOD OF 40 YEAES OF AGE 104 THE HEART AND THE AORTA Finally—and this agrees with the preceding data—thelongitudinal diameter exceeds the normal, and the hori-zontal diameter is decidedly less. In the right posterior oblique position (Fig. 69), theapex of the heart disappears behind the vertebral columnonly at a wide angle, a fact which is easily explained, ifit is granted, as has been shown, that hypertrophy of theleft ventricle in its early stage affects the mediastinalarea. Sometimes the enlargement is so slight that it canbe shown only by determining index Fig. 69. SAME CASE, IN EIGHT POSTEEIOE OBLIQUE POSITION At an angle of 40 degrees, the apex of the heart has not yet disappearedbehind the vertebral column. The preceding images, therefore, lead to the conclusionthat the patient is suffering from marked hypertrophyof the left ventricle without involvement of the othercavities. This view of the heart is characteristic ofsevere aortic insufficiency when it has not yet given riseto grave symptoms. It is necessarily completely modi-fied when it is caused by asystolic disturbances whichprovoke secondary deformations of the other cardiaccavities. The hypertrophy of the left ventricle is sometimes soslight in the course of aortic lesions that it might easilyescape attention if recourse were not had to the different
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