. The heart and the aorta; studies in clinical radiology . nlyslightly pushed outward; moreover, it is rounded andis not separated from the left diaphragm during forcedinspiration. The general form suggests somewhat apurse, the bottom of which would correspond to the heartapex. The contour of the left ventricle is elongated, convex,but not exaggerated. Point Gr, though not very abnor-mally elevated, lies a little too high, being on the sameline as the corresponding point D. Finally, the wholelength of the left outline shows systolic pulsations ofmarked amplitude and force. The right contour is
. The heart and the aorta; studies in clinical radiology . nlyslightly pushed outward; moreover, it is rounded andis not separated from the left diaphragm during forcedinspiration. The general form suggests somewhat apurse, the bottom of which would correspond to the heartapex. The contour of the left ventricle is elongated, convex,but not exaggerated. Point Gr, though not very abnor-mally elevated, lies a little too high, being on the sameline as the corresponding point D. Finally, the wholelength of the left outline shows systolic pulsations ofmarked amplitude and force. The right contour is normal and this contour, more-over, is not modified except at the period when functionaldisturbances appear; the presence of systolic pulsations,perceptible rather high above the diaphragm, does notnecessarily indicate hypertrophy or dilatation of the ven-tricle to the right; it may simply mean that the ventricleis pushed back as a result of the lowering of the heartand its displacement toward the median line, because ofthe weight of the left Fig. 68. AOETIC INSUFFICIENCY. PEEIOD OF 40 YEAES OF AGE 104 THE HEART AND THE AORTA Finally—and this agrees with the preceding data—thelongitudinal diameter exceeds the normal, and the hori-zontal diameter is decidedly less. In the right posterior oblique position (Fig. 69), theapex of the heart disappears behind the vertebral columnonly at a wide angle, a fact which is easily explained, ifit is granted, as has been shown, that hypertrophy of theleft ventricle in its early stage affects the mediastinalarea. Sometimes the enlargement is so slight that it canbe shown only by determining index depth.
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