. A practical treatise on medical diagnosis for students and physicians . erious effect upon thepulmonic and arterial circulation than any other valvular disease. Theseeffects must be understood in order to appreciate the symptoms of mitralincompetence, which are as follo^vs : MITRAL liEa URGITATIOX. 949 1. With each systolic contraction, ou account of the insufficiency ofthe mitral leaflets, the blood flows back to the auricle, where it soonmeets a volume of blood coming from the lunos. The combined volumesof blood over-distend the auricle. Dilatation ensues, and because ofincreased work to g
. A practical treatise on medical diagnosis for students and physicians . erious effect upon thepulmonic and arterial circulation than any other valvular disease. Theseeffects must be understood in order to appreciate the symptoms of mitralincompetence, which are as follo^vs : MITRAL liEa URGITATIOX. 949 1. With each systolic contraction, ou account of the insufficiency ofthe mitral leaflets, the blood flows back to the auricle, where it soonmeets a volume of blood coming from the lunos. The combined volumesof blood over-distend the auricle. Dilatation ensues, and because ofincreased work to get rid of the increased contents, hypertrophy hypertrophy of the left auricle is the first eftect. 2. As a result of the above, a larger amount of blood is forced fromthe left auricle into the left ventricle ; in order to remove the increasedamount of fluid, dilatation and subsequent hypertrophy of this chamberfollow. Fig. 350. Lungs Congested HeartValvular Lesions- Portal Congestion Gastric Catarrh Dilated Veins{Caput Medusae) Intestinal CatarrhAscites. SpleenCongested andEnlarged Hemorrhoids Oedema ofLoicer Extremities Showing the congestions following valvulitis with failure of compensation. 3. On account of the over-distended auricle the pulmonary veins arenot fully emptied during the diastole of that chamber. The veins aretherefore engorged and interfere with the flow of blood through the pul-monary circuit. In consequence of the impeded flow of blood the vesselsin the pulmonary circuit are dilated and over-distended. The right ven-tricle is compelled to act more vigorously, and even then can not emptyitself freely. Dilatation and hypertrophy of the right ventricle ensue. 4. This condition causes obstruction to the flow of the blood from 950 JJliiLASKS OF THE HEART, BLOODVESSELS, AND MEDIASTINUM. the right auricle to the right ventricle : dilatation and hypertrophy of theright auricle follow. If perfect compensation ensues through hypertrophy of both ventri
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