Diseases of the heart and circulation in infancy and adolescence . ed bya soft, purring, systolic bruit at the same valve. No aorticdisease could be discovered; both sounds are heard withdistinctness at the ensiform cartilage, and at the pulmonaryarea the second sound is markedly accentuated. The mitralmurmur has a wide distribution, is just heard immediately tothe left of the sternum in the second and third interspaces,increasing in intensity as the apex is approached and passedand carried on to the angle of the left scapula. There is no arterial pulsation visible at the wrist. Cardiac dulnes
Diseases of the heart and circulation in infancy and adolescence . ed bya soft, purring, systolic bruit at the same valve. No aorticdisease could be discovered; both sounds are heard withdistinctness at the ensiform cartilage, and at the pulmonaryarea the second sound is markedly accentuated. The mitralmurmur has a wide distribution, is just heard immediately tothe left of the sternum in the second and third interspaces,increasing in intensity as the apex is approached and passedand carried on to the angle of the left scapula. There is no arterial pulsation visible at the wrist. Cardiac dulness began an inch to the right of the sternum,and extended to the eighth interspace at the posterior axillaryline. The distance from the nipple to the extreme left point 118 Keating and Edwards : Diseases of the Heart of dulness was three and a half inches. The greatest area ofdulness from right to left was eight inches. These points areindicated by the iodine line on the skin seen in the photo-graph. Palpation reveals a thrill and apex-beat in the sixth, seventh,. a. Spinous process of vertebrae, b, Extreme right of chest, c, Extreme left of chest,d, Sternum, e, /, g, h, Abnormal anterior body of chest. {, /, k, I, Normal anterior bodyof chest. and eighth interspaces, the maximum intensity being in thesixth and seventh. The bony chest-encasement, in cases of extreme increase incardiac volume, will, in the young, be much altered, as maybe appreciated by noting the chest tracing taken from theabove case with a lead-tape. The child presented but few, if any, symptoms of cardiac and Circulation in Infancy and Adolescence. 119 disease, except the physical; there was no dropsy or otherconcomitant, except shortness of breath, for which symptomshe sought medical advice. She and her friends can recollectno attack of acute disease, and state that the child has hardlybeen sick a day in her life. TRICUSPID DISEASE. Primary disease of the tricuspid valve is somewhat un-usual if we exclude ca
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectheartdi, bookyear1888
