File:Medical diagnosis for the student and practitioner (1922) (14597983629).jpg

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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tnervous irritability in many instances. Pain.—It is almost inevitable that the coronary arteries should suffer a * There is no doubt in the authors mind relative to the occasional occurrence of theFlint murmur, but quite as little to its rarity. Nearly all such cases prove at autopsy tobe due to an associated organic mitral stenosis. \ORTIC STENOSIS 721 loss of equal calibration and normal elasticity which, together with myocardial Minor anddegeneration and the unstable nervous balance, leads to various types of major angina-arrhythmia and superadds the various painful expressions of angina minoror major so valuable in diagnosis. Dyspnea.—Dyspnea, though usually and for long periods less manifest Dyspnea,than in mitral lesions, is often extreme or even paroxysmal if the myocardialweakness is marked or the coronary changes decided. Sources of Danger.—The nervous system being extremely labile, fear, .anger, joy and sorrow, the excessive use of tea, coffee, tobacco, or stimulants,
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Fig. 391.—Chronic aortic endocarditis with extreme stenosis. Lumen reduced tothree slit-like openings meeting in the center. Estimated reduction in lumen, 75 per cent.There was marked hypertrophy of the left ventricle. Case of man, age 80, who diedof apoplexy. Kidneys showed advanced stage of chronic diffuse nephritis. sexual excess, and mental as well as physical overstrain of any kind, mayprove not only potent factors in the excitation of symptoms, but, in the caseof the major factors, the cause of fatal decompensation or sudden death. It is evident that aortic insufficiency must constitute one of the commoner MaykiUcauses of sudden death and in this, as in every other case of heart disease, suddenly-the relatives should understand the possibility of a dramatically tragic exitus. AORTIC STENOSIS Etiology.—True aortic stenosis is a relatively uncommon lesion, affectingthe adult male almost exclusively, and, as an isolated lesion, constitutes a clinical46 722 MEDICAL DIAGNOSIS rar

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