File:Clinical disorders of the heart beat - a handbook for practitioners and students (1916) (14783005213).jpg

Identifier: clinicaldisorder1916lewi (find matches)
Title: Clinical disorders of the heart beat : a handbook for practitioners and students
Year: 1916 (1910s)
Authors: Lewis, Thomas, Sir, 1881-1945
Subjects: Arrhythmia Arrhythmias, Cardiac
Publisher: New York : P.B. Hoeber
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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remature contractions while standing, may soon lose themin recumbency, and this despite a slight decrease of heartrate in the last position. In other patients, pressure uponthe abdomen may abolish them. The recognition of premature contractions. The work accomplished by premature beats is small,because the periods of rest that precede them are short.They may or may not raise the aortic valves. Accompanyingthe premature beat, a feeble pulsation or a prolonged pauseis noted in the arterial pulse ; auscultation reveals earlyfarst and second sounds when the aortic valves are forced,but only an isolated and premature first sound if the ven-tricular pressure fails to top the arterial. The consequentgrouping of sounds in threes and fours is comprehended whenthe nature and degree of the corresponding arrhythmia arediscerned. The commonest arrangements of pulsations andsounds are described in the following paragraphs, and areillustrated by the accompanying diagram and tracings. 4(5 Chapter IV.
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§ Fig. 24. A diagram showing common disturbances of the arterial pulse andheart sounds when premature ventricular contractions are present,(a) Normal rhythm ; (b) Occasional premature beat, which affects arterialpressure ; (c) Occasional premature beat, which fails to affect arterial pressure ;(d) Premature beat replacing each third normal beat and affecting arterialpressure ; (-e) Premature beat replacing each third normal beat and failing toaffect the arterial pressure ; (/) Premature beat replacing each second normalbeat and affecting the arterial pressure ; (g) Premature beat replacing eachsecond normal beat and failing to affect arterial pressure. The heart soundsoccur in groups, and the groups are of four or three, according as the aorticvalves are raised or remain at rest when the premature beat occurs. Premature Contractions. 47 In the succeeding- paragraphs I have sub-grouped thesymptoms according as the premature beat (a) raises or (ft)fails to raise the aortic valves. 1. W

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