Auricular flutter

411

ABSTRACTS

Pakrkineon, John, and Beford, D. Evan: Thrombosis. Laneet, 1928, i, 4.

Cardiac

Infarction

and

Coronary

The present paper is based on the clinical study of 100 patients who had experienced one or more prolonged severe attacks of angina1 pain and in whom no’ diagnosis other than myocardial infarction seemed possible. Doubtful cases and those of post-mortem interest only have been excluded. A supplementary study has been made from the records of the Pathological Institute of the London included. analyzed onset

Hospital from 1922 to 1926 for The various data concerning in detail. The high incidence and

the

association

from other similar clinical features. infarction of such period which

sudden

death

Altogether 83 such cases are infarction and thrombosis are affected, the suddenness of the coincide

studies. The authors describe They believe that as a rule the

is characteristic a cardiac lesion. between the R-T

with

comparison. cardiac of males

and occasionally it The diagnostic feature

with

the

the various electrocardiogram provides is the

the RS- and T-waves, so that a plateau interval is either elevated or depressed.

figures

usual

gained

and special after cardiac

the only objective sign absence of an isoelectric type

of

curve

results

in

Berman, P., and Mason, V. I%.: Coronary Artery Disease and Electrocardiographic Study. Calif. and Western Med., 1928, xxviii, 334. The authors consider the changes in the electrocardiogram described by Pardee a;s being specific in the diagnosis of coronary thrombosis. They describe this as a downward sharply peaked T-wave with an upward convexity of the S-T or I&T interval in all or any leads except Lead III. When this type of curve oNecurs in Lead III with other signs of myocardial damage, it may be of importance. The authors have studied electrocardiograms showing these changes in relation to the clinical course shown by patients in four groups. Group one includes patients in whom a diagnosis of coronary occlusion made by c.linical and electrocardiographic methods was confirmed by post-mortem findings. In an eclual period of time there were in the hospital 13 patients who had no electrocardiograms made, but showed occlusion of the coronary artery at autopsy. No clinical diagnosis of the condition had been made in this group. there were symptons of coronary In a second group, including 18 patients, thrombosis with characteristic electrocardiograms, but in whom there were no autopsies. The electrocardiograms showed other signs of myocardial injury and the patients had clinical signs to coincide with these findings. Group three includes 9 patients all with syphilitic heart disease. These all showed characteristic coronary T-wave changes. Group four included 19 patients with characteristic coronary T-wave changes in the electrocardiogram but in whom no clinical diagnosis of occlusion could be made. None of these patients had come to autopsy. The authors feel that the occurrence of such changes in the electrocardiogram are of value in the diagnosis of coronary thrombosis.

Sprague, Howard B., a& Assn., 1925, xc, 1772. In and

by

a man aged forty-nine electrocardiogram.

White,

The

Paul D.:

auricular condition

Auricular

flutter had

Flutter.

Jour. Am. Med.

was diagnosed from the history existed apparently for five years

412

THE

AMERICAN

HEART

JOURNAL

and was unchecked by digitalis or quinidine in full dosage. No cause for the disturbance in mechanism could be found nor was there any evidence of heart The flutter finally stopped abruptly for no known reason. Not infredisease. quently during the course of the flutter, the ventricular rate followed the aurieular, without block, at from 240 to 260 beats a minute. At such times palpitation and weakness were distressing.