The irregular pulse : its value in prognosis ; Stokes-Adams disease : report of a case / by John Hay.

  • Hay, John, 1873-1959.
Date:
1906
Catalogue details

Licence: In copyright

Credit: The irregular pulse : its value in prognosis ; Stokes-Adams disease : report of a case / by John Hay. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    hand over the heart we perceive an irregularity which makes itself evident by the presence of a short impulse occurring very early in the diastole, then a long pause ending in an extremely strong and forcible apex beat, followed by the normal rhythm. On auscultation one finds the same sequence. Tn fig. 4 we have a diagram showing the occurrence of two extra systoles. The upper tracing is a cardiogram, and recorded simultaneously with the radial pulse. The first extra-systole occurs so early in diastole that the Simultaneous tracings of the apex beat and of the radial pulse, showing the occurrence of tw’o extra systoles, vx. The first occurs very early in the diastole of the ventricle, the second is later in its appearance. contraction of the left ventricle is unable to overcome the pressure in the aorta, the semilunar valves remain closed, and there is a dropped beat at the wrist. The sounds heard in such a case are represented at the foot of the diagram ; and since during the first extra-systole the aortic valves remain closed, the contraction of the ventricle gives rise to a single sound ; it corresponds to a first sound, and follows rapidly on the previous short, sharp second sound. Sometimes this sequence of sounds simulates very closely a reduplication of the second sound.