. The heart and the aorta; studies in clinical radiology . centuated. The transverse enlargement of the heart isconsiderable; it is very much lowered on the right whereits greatly elongated contour deviates progressively fromthe median line to the level of the diaphragm. The apexis elevated and pushed to the left, toward the thoracicwall. Both diameters are increased and the horizontal ismuch greater than the longitudinal. On the screen pulsa-tions were seen to be very feeble, especially in the rightventricular area. VALVULAR AFFECTIONS 91 In these cases, radiological examination only confirms
. The heart and the aorta; studies in clinical radiology . centuated. The transverse enlargement of the heart isconsiderable; it is very much lowered on the right whereits greatly elongated contour deviates progressively fromthe median line to the level of the diaphragm. The apexis elevated and pushed to the left, toward the thoracicwall. Both diameters are increased and the horizontal ismuch greater than the longitudinal. On the screen pulsa-tions were seen to be very feeble, especially in the rightventricular area. VALVULAR AFFECTIONS 91 In these cases, radiological examination only confirmsan evident diagnosis. There are other cases in which theclinical signs were less clear and in which radiologicalexamination nevertheless gave the same results. Orthodiagram 57 is of a woman who had an apical sys-tolic murmur but who showed no functional trouble thatwould indicate a cardiac lesion. By fluoroscopic examination there seemed to be nonotable modifications. The diameters measured: hori-zontal, cm.; longitudinal, cm., about the normal. Fig. 57. SLIGHT MITEAL INSUFFICIENCY. WOMAN 32 YEAKS OF AGE figures. However, the right outline was slightly exag-gerated, and in deep inspiration the inferior contour ofthe heart clearly projected over the diaphragm, whichcould be explained only by an enlargement of the rightventricle. Moreover, by goniometer readings, the apexdisappeared behind the shadow of the vertebral columnonly at an angle of 40 degrees. The heart, therefore, waspathological, and the changes found, such as an increase 92 THE HEART AND THE AORTA of the right contour, lowering of the inferior margin ofthe corresponding ventricle, disappearance of the apexat too great an angle of incidence, proved that a moderatebut indisputable enlargement of the heart, especially ofthe right ventricle, existed, indicating mitral insufficiency. These proofs are of practical importance in relation todifferential diagnosis of systolic murmurs of the apex,which is at times d
Size: 1440px × 1735px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1920, bookidheartaortast, bookyear1920
