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Showing papers in "Medizinische Monatsschrift für Pharmazeuten in 2004"







Journal Article
TL;DR: The electrocardiographic findings were Indicative of myocardial degeneration; they revealed considerable delay In Intraventricular conduction (partial bundle branch block).
Abstract: line. There were typical signs of aortic incompetence,and probably a mitral lesion was presentas well. The systolic blood pressurewas 144 and the diastolic 30 millimetres of mercury. An electrocardiogramrevealedearly heart block (a prolonged PR interval). The blood sedimentationrate had gradually fallen from a very high figure to six millimetres in one hour. A point of great interest was that a teleradiogram made on December 7 revealed transverse enlargementof the heart greatly in excessof that shown by films in August and September,when the size was within normal limits. The unusually rapid valvular involvement with resulting incompetenceof the aortic valves was a further point of interest which was stressed. Captain Day's fifth patient, aged forty-seven years, was suffering from coronary artery atherosclerosiswith myocardial degeneration. Dyspnceaon exertion, first noticed in 1938, had steadily increased, and attacks of nocturnal dyspnceahad gradually installed themselves. On examination, no demonstrablecardiacenlargementwas present. The heart soundswere of rather poor quality, and an inconstant triple rhythm was to be heard at and near the apex. The systolic blood pressurewas 145 and the diastolic 94 millimetres of mercury. No other physical signs were present and the urine was clear. The Kline test producedno reaction. A teleradiogramshowed the heart size to be within normal limits. The electrocardiographic findings were Indicative of myocardial degeneration; they revealed considerable delay In Intraventricular conduction (partial bundle branch block). Captain Day pointed out that this patient illustrated the type of slowly progressivecoronary artery sclerosis without arterial hypertensionor any considerable cardiac enlargement. He stressedthe importance of recognizing gallop rhythm In such cases, when it was present. CaptainDay's last patientwas suffering from hypertensive heart disease. He was forty-one years of age, and had been well until five or six months prior to his admission to hospital. Since then he had becomebreathlesson exertion. This condition had been worse for three months, and for this period he had also had attacksof paroxysmalnocturnal dyspncea, All symptoms had decreasedwith rest. The patient was an obeseman. The heart was greatly enlarged, the apex beat being palpable In the sixth left intercostal space in the anterior axillary line. The pulse was regular and there were no murmurs. A constant triple rhythm could be heard at and internal to the apex beat. It was difficult to time, but was probably protodlastolic. There were no other physical signs. The systolic blood pressure ranged from 185 to 190 and the diastolic from 125 to 130 millimetres of mercury. The specific gravity of the urine, which contained neither albumin nor sugar, was 1,018. A teleradiogramrevealed gross transverseenlargementof the heart. An electrocardiogram,rather surprisingly, revealed no left axis deviation. There were slight changesIn some of the T waves and QRS complexes, considered to be Indicative of some degree of myocardial degeneration .

3 citations