. Medical diagnosis for the student and practitioner. to exceptions, the authors personal expe-rience has not confirmed the perfectly reasonable and logical statements of Bamberger,Romberg, D. Gerhardt and others that mild grades of stenosis are associated with regurgi-tation and the extreme grades are not. In several of his cases representing the maximaldegrees of obstruction the regurgitation has been plainly manifest. This in fact was thecase in the most extreme aortic stenosis which he has seen at autopsy. t Its marked predominance in the male strongly suggests that lues is a more potentfa
. Medical diagnosis for the student and practitioner. to exceptions, the authors personal expe-rience has not confirmed the perfectly reasonable and logical statements of Bamberger,Romberg, D. Gerhardt and others that mild grades of stenosis are associated with regurgi-tation and the extreme grades are not. In several of his cases representing the maximaldegrees of obstruction the regurgitation has been plainly manifest. This in fact was thecase in the most extreme aortic stenosis which he has seen at autopsy. t Its marked predominance in the male strongly suggests that lues is a more potentfactor than we have been led to believe in times past. AORTIC STENOSIS 723 The Murmur.—Time.—Systolic, but actually following the first sound sughtiyby a fractional interval representing the presphygmic period which in thislesion is slightly prolonged. Quality.—A loud harsh bruit usually of a hissing or sawing character Usually loud ... , . r i i • 1 it and harsh. which in association with aortic regurgitation frequently results in the see-. Fig. 393.—Aortic stenosis. A sphygmographic tracing is shown, and three varietiesof the aortic systolic murmur are represented graphically. Diagrammatic representation ofthe heart in systole, stenosis of the aortic valve being present; the mitral and tricuspidvalves have closed; the right ventricle is nearly empty; the left ventricle is still more thanhalf full of blood, because of the obstruction present at the aortic orifice. Result.—A sys-tolic murmur in the aortic area; enlargement of left ventricle, etc. hv. Mitral valve. valve, av. Aortic valve, pv. Pulmonary valve. LA. Left auricle. RA. Rightauricle. LV. Left ventricle. RV. Right ventricle. VCS. Vena cava superior. cava inferior. P. Vn. Pulmonary veins. Pulmonary artery. AO. Aorta. saw murmur, quite accurately reproducing the double sound of a wood sawin action. Maximum Intensity and Transmission.—The murmur possesses fewvagaries, is heard bes
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1922
