. The heart and the aorta; studies in clinical radiology . rdinary methods of radiological teleradiogram (Fig. 70) is a typical case. The ap-pearance of serious functional disturbances only in-creases ventricular hypertrophy, which may attain ex-cessive dimensions, as shown in Fig. 71. Radiological examination is able also to demonstratethe coexistence with aortic insufficiency of valvular cardi-opathy, notably of mitral stenosis. This is interesting,for it has been assumed, for purely theoretical reasons,that the association of these two lesions was a ratherfavorable condition
. The heart and the aorta; studies in clinical radiology . rdinary methods of radiological teleradiogram (Fig. 70) is a typical case. The ap-pearance of serious functional disturbances only in-creases ventricular hypertrophy, which may attain ex-cessive dimensions, as shown in Fig. 71. Radiological examination is able also to demonstratethe coexistence with aortic insufficiency of valvular cardi-opathy, notably of mitral stenosis. This is interesting,for it has been assumed, for purely theoretical reasons,that the association of these two lesions was a ratherfavorable condition. But in the great majority of cases 106 THE HEART AND THE AORTA the coexistence of a mitral stenosis with aortic insuffi-ciency has been based only on the presence of a presys-tolic murmur at the level of the apex. This is not suffi-cient, and today we know that simple aortic insufficiencyis often accompanied by a murmur which has nothing todo with mitral stenosis and which is due exclusively tointra-ventricular circulation provoked by the reflux of the. Fig. 71. AOETIG INSUFFICIENCY, ASYSTOLIC PERIOD Considerable hypertrophy of the left ventricle, dilatation of the rightcavities. blood; what has been known as Flints murmur. It isnot surprising that aortic insufficiency accompanied bya murmur should generally be a favorable prognosis, foraortic insufficiency alone is not accompanied by any otherlesion. On the other hand, where there is a combinationof aortic insufficiency and mitral stenosis, the prognosisis always more serious. In pathology as in arithmetic,one and one make two, and an isolated lesion of the heartentails less risk than a double lesion. But how shall it be determined whether aortic insuffi-ciency is complicated with mitral stenosis, when the most VALVULAR AFFECTIONS 107 characteristic sign of this latter affection, the murmur,is found in both cases ? There is only one way of decidingit: that is to determine the volume of the left auricle,which is always increa
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