ISBN: 9781230157979

This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not … Plus…

This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1907 edition. Excerpt: ...much overestimated. If cyanosis is persistent, it is a valuable indicator, but its absence proves nothing in regard to congenital heart disease. When present, cyanosis is more evident under the influence of such acts as crying, coughing, or, in fact, of any unusual exertion. It is much more constant in congenital heart than in the acquired forms of disease. Murmurs are usually present, the most characteristic being a systolic murmur, which is most intense at the left base and very diffused. The kinds of murmur present are not of considerable diagnostic import; the real value comes in their being loud. Loud diffused murmurs which are associated with cyanosis are almost invariably due to congenital heart disease, while loud apex murmurs are indicative of the acquired forms. In congenital heart disease there is generally more or less en largement present (evidenced by dullness extending to the right of the sternum, with displaced apex-beat to the right), and there may be bulging over the precordia or at the lower end of the sternum. It is not always easy to decide that the case is one of congenital disease, for anemia offers some similarity at times. However, if the murmur exists alone and the child is anemic, the evidence is strong against congenital heart. As a result of congenital heart the child is generally stunted in its growth and development, many of such children remaining rather puny and weak. For practical purposes it is not necessary to distinguish between the different types of lesions which are present. In most instances it is impossible to do so anyway, because of the prevalence of many lesions in one case, and the rapidity of the heart''s action does not allow of a proper appreciation of the different sounds and conditions... Le Grand Kerr, Books, Fiction and Literature, Diagnostics of the diseases of children Books>Fiction and Literature <