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A comparison of precordial electrocardiograms obtained with CR, CL, CF, and V leads
The therapeutic remedies used to date are discussed, and the form is described in which quinidine sulfate has been used orall!. with good results and without untoward effects. The mechanical procedure of vagal stimulation gave good results in two (‘~is(~:i observed. (‘.~I,(‘IFICATION OF THE MYOC’ARDII;RI.-L,uI~ M.D., AND ):I. VOOGL, M.D., ROSAKIO, .~KGEiTIN.I. Abstract in English not available.
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NEWER CONCEPTS CONCERNING THE SYNDROME 01; SHORT P-R INTERVAL AND WIDE QRS COMPLEX.-- -Ju.I\N (;ovf,..\ I’I<~.\, M.D., HAVANA, CUBA. Abstract in English not available. CAARDIAC LESIONS IN RHEUMATOID ARTHRITIS.-IRVING GKAEF, M.D., DANIEL V. HICKEY, M.D., AND VLADIMIK ALTMANN, %T.D., NEW \-oRK, N. Y. The protocols and available microscopic sections of the heart were reviewed for cardiac lesions in sixty-six cases of rheumatoid arthritis studied at necropsy between 1939 and 1948 at the Goldwater Memorial Hospital, Welfare Island, New York City. There were thirty men and thirty-six women distributed according to age between the third and ninth decades. The mean age for both groups was in the seventh decade; the mode of their distribution fell in the sixth and seventh decades. Antecedent rheumatic fever was reported in the history of one patient. Gross valvular deformities were observed in twenty-nine cases; of these, nineteen were regarded as of the rheumatic type, but mild. In only one was there mitral stenosis. In five additional casesmicroscopic examination disclosed old rheumatic valvulitis. In two there were granulomatous zones of interstitial collagenous necrosis undistinguished from those seen in rheumatoid subcutaneous nodules. Pericarditis consisting usually of old adhesive or obliterative lesions was found in one-half of the cases. In four, clinically unsuspected acute fibrinous pericarditis was found. In one a group of necrotic collagenous nodules with a granulomatous reaction like those seen in subcutaneous nodes was seen in histologic preparations. Myocardial lesions included seven instances with active chronic inflamAmong these there were five of the granulomatory interstitial myocarditis. matous type which resembled Aschoff nodules. In addition, perivascular fibrosis of significant degree and characteristically arranged;ini“onionskin” layers was found in about two-fifths of the cases.’ In two cases lesions like those of periarteritis nodosa were found in the coronary arteries, although periarteritis nodosa was unsuspected ante mortem. On the basis of these results there were twenty-six cases with definite rheumatic types of cardiac lesions and nine others which were probably rheumatic, but in them the evidence was not conclusive. These data indicate that careful study: of the heart in rheumatoid arthritis is warranted, even in the absence of overt clinical or gross pathologic deformities. The evidence of cardiac involvement resembles that seen in rheumatic fever, but is lessdiffuse or severe, as :I rule. .A COMPARISON OF PRECORDIAL ELECTROCARDIOGRAMS TAINED WITH CR, CL, CF, AND V LEADS.-SIDNEY GRXU, MARTIN DOLGIN, M.D., AND LOUIS N. K.~Tz:. YT.D., Crxac,o, ILL. Published in full, Am. Heart J. 37: 343, 1949.
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NEWER CONCEPTS CONCERNING THE SYNDROME 01; SHORT P-R INTERVAL AND WIDE QRS COMPLEX.-- -Ju.I\N (;ovf,..\ I’I<~.\, M.D., HAVANA, CUBA. Abstract in English not available. CAARDIAC LESIONS IN RHEUMATOID ARTHRITIS.-IRVING GKAEF, M.D., DANIEL V. HICKEY, M.D., AND VLADIMIK ALTMANN, %T.D., NEW \-oRK, N. Y. The protocols and available microscopic sections of the heart were reviewed for cardiac lesions in sixty-six cases of rheumatoid arthritis studied at necropsy between 1939 and 1948 at the Goldwater Memorial Hospital, Welfare Island, New York City. There were thirty men and thirty-six women distributed according to age between the third and ninth decades. The mean age for both groups was in the seventh decade; the mode of their distribution fell in the sixth and seventh decades. Antecedent rheumatic fever was reported in the history of one patient. Gross valvular deformities were observed in twenty-nine cases; of these, nineteen were regarded as of the rheumatic type, but mild. In only one was there mitral stenosis. In five additional casesmicroscopic examination disclosed old rheumatic valvulitis. In two there were granulomatous zones of interstitial collagenous necrosis undistinguished from those seen in rheumatoid subcutaneous nodules. Pericarditis consisting usually of old adhesive or obliterative lesions was found in one-half of the cases. In four, clinically unsuspected acute fibrinous pericarditis was found. In one a group of necrotic collagenous nodules with a granulomatous reaction like those seen in subcutaneous nodes was seen in histologic preparations. Myocardial lesions included seven instances with active chronic inflamAmong these there were five of the granulomatory interstitial myocarditis. matous type which resembled Aschoff nodules. In addition, perivascular fibrosis of significant degree and characteristically arranged;ini“onionskin” layers was found in about two-fifths of the cases.’ In two cases lesions like those of periarteritis nodosa were found in the coronary arteries, although periarteritis nodosa was unsuspected ante mortem. On the basis of these results there were twenty-six cases with definite rheumatic types of cardiac lesions and nine others which were probably rheumatic, but in them the evidence was not conclusive. These data indicate that careful study: of the heart in rheumatoid arthritis is warranted, even in the absence of overt clinical or gross pathologic deformities. The evidence of cardiac involvement resembles that seen in rheumatic fever, but is lessdiffuse or severe, as :I rule. .A COMPARISON OF PRECORDIAL ELECTROCARDIOGRAMS TAINED WITH CR, CL, CF, AND V LEADS.-SIDNEY GRXU, MARTIN DOLGIN, M.D., AND LOUIS N. K.~Tz:. YT.D., Crxac,o, ILL. Published in full, Am. Heart J. 37: 343, 1949.
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