Identifier: medicaldiagnosi00gree (find matches)
Title: Medical diagnosis for the student and practitioner
Year: 1922 (1920s)
Authors: Greene, Charles Lyman, 1862-
Subjects: Diagnosis
Publisher: Philadelphia, Blakiston
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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t. Soft systolic bruit at apex. Apex beat diffuse, systolicretraction marked over right ventricular area. True apex beat diffuse, sharp and un-sustained. Superficial and deep dulness well defined to left of sternum, former showingextension to right sternal border. Area of relative dulness to right of this point not accu-rately definable. In a second picture taken a few weeks later a better plate and exposurebrought out the areas of residual infiltration and extremely dense hilus shadows remi-niscent of the causative influenzal broncho-pneumonia. The former are suggestedfaintly in the shadow of the right ventricle (to the left of the sternum) and also over thesame chamber to the right of the sternum. Both this and the final radiogram, showingthe resumption of the narrow drop heart outline normal for its congenitally asthenicpossessor are shown under Drop heart. Acute dilatation may involve the right, leftor both chambers of the heart. (See also Figs. 424, 425 and 427.) IKKIlAKDlllS 78S
Text Appearing After Image:
Fig. 427.—A case of chronic universal enlargement of a heart primarily of the normaltype. (Dorso-ventral aspect.) Hypertrophy and dilatation are present, the patient, anunusually powerful broad-chested man, attends to his business as a building contractor, butcarries hepatic engorgement, diurnal edema of the ankles and persistent rales at the lungbases. Is exhausted easily and has decided exertion dyspnea. A fatty tail indicatingsome degree of fatty overgrowth (fatty infiltration, fatty heart). It will be notedthat this condition obliterates both right and left inferior angles. Total transverse meas-urement 19 cm. If this myocardium were to become profoundly toxic, during a pneu-monia, influenza, septic cholecystitis, acute rheumatism or other such prostrating ailmentsuch a heart might assume the form shown in Fig. 424, a silhouette usually exaggerated, asto the loss of the lower left ventricular curve, by the high position of the diaphragm so oftenpresent, according to the authors

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