The student's guide to medical case-taking / by Francis Warner.

Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: The student's guide to medical case-taking / by Francis Warner. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    HYPERTROPHY OF HEART. Inspection.—Heart's impulse may be seen over an extended precordial area, shaking and thnisting forward the chest- -walls. Apex-beat displaced, usually outwards and down- wards. In children the cardiac area may be bulged forward. Palpation.—Shook of heart against chest-wall very distinct, raising the hand or stethoscope. Impidse felt in several interspaces. Epigastric pulsation if right ventricle is hypertrophied. Pulse full and strong in proportion to the hypertrophy. Auscultation.—FivBt sound prolonged, duU, strong. Aortic 2nd sound intensified. Mte diagnosis from pericardial effusion by intensity of Ist sound coinciding with in- creased area of dulness. Tcrcimion.—Axea, of dulness. Left ventricle enlarged down- wards and outwards, and may extend a little upwards. Eight ventricle enlarged laterally, and may extend to right of sternum. HYPERTROPHY AND DILATATION. Causation— Obstructions in the pulmonary circulation {right heart affected).—Emphysema. Chronic bronchitis. Chronic plem-isy. Adhesions of lung preventing expansion. Obstructions in the aortic circulation {primarily affecting left si«?e).—Arterial disease. Chronic Bright's Disease with thickening of small arteries. General plethora. Eepeated pregnancies. Causes originating in or about the heart.—Primaiy dilatation, e.g., after fevers, ia Anaemia. Valvular disease and stenosis of the outlets. Adherent pericardium. Excessive exercise. Displacements of the Heart. Mal- formations. Emotional distui-bance long continued. Eatty or other form of degeneration.