. The heart and the aorta; studies in clinical radiology . Fig. 89. PULMONARY STENOSIS p, apex of the left heart; p, apex of the right ) (Heart en 124 THE HEART AND THE AORTA the apex of the right ventricle is rounded and the inferiorcontour of the heart descends much lower than right contour greatly overlaps the sternum. In thevicinity of the diaphragm very ample systolic pulsationsof the hypertrophied right ventricle are seen. Finally,the left median arc or pulmonary arc shows an abnormalsalience in its upper part. 2. Nina P., twenty-three years of age, with Fried-re
. The heart and the aorta; studies in clinical radiology . Fig. 89. PULMONARY STENOSIS p, apex of the left heart; p, apex of the right ) (Heart en 124 THE HEART AND THE AORTA the apex of the right ventricle is rounded and the inferiorcontour of the heart descends much lower than right contour greatly overlaps the sternum. In thevicinity of the diaphragm very ample systolic pulsationsof the hypertrophied right ventricle are seen. Finally,the left median arc or pulmonary arc shows an abnormalsalience in its upper part. 2. Nina P., twenty-three years of age, with Fried-reichs disease (case reported by Babinski), gives a verylocalized murmur in the left second intercostal space,transmitted toward the clavicle. Slight tremor attacksof paroxysmal tachycardia with syncope. Slight Fig. 90. NINA P., 23 YEAES OF AGECONGENITAL PULMONARY STENOSIS The orthodiagraphic tracing of this patient (Fig. 90)presents the same characteristics as the preceding, butwith the following differences: a greater development ofthe heart, apex of the left ventricle elevated and pushedoutward, lower contour of the right ventricle exaggeratedand displacement of the right cavities toward the diameters are: Longitudinal diameter cm Horizontal cm DG cm CONGENITAL AFFECTIONS 125 Finally, the median arc or the pulmonary arc makes aconsiderable salience. 3. Mile. Mu., twenty years of age; systolic murmurheard in the second left intercostal space, purring thrill,dyspnoea.
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