The social incidence of rheumatic heart disease

283

ABSTRACTS nostic significance. severe. Disturbances favorable prognostic

Battro,

Antonio,

Argentina

If

both types occur at the same time, prognosis becomes of rhythm, other than isolated extrasystoles, have an unsignificance.

and Del Rio, Julio

de Card.

Systematic

1: 192,

use of Lead

IV

G.:

Lead IV in Electrocardiography.

Rev.

1934. has

led to the

following

conclusions:

Lead IV should be recorded in all angina1 syndromes: in four out of twenty patients with angina, there was definite electrocardiographic evidence of myocardial infarction in Lead IV, while the conventional leads were ,practiaally normal. Lead IV has also proved of value in determining complexes which are not far from normal in the conventional leads but which are true extrasystoles in Lead IV. Lead IV, however, does not allow a clear distinction between right Right bundlc-branch block showed a conand left ventricular extrasystoles. cordant positivity of the main initial deflpctions in Lead IV and Lead I. Conversely, left bundle-branch block showed a concordant negativity of the main initial deflections in the same leads. Rivolta, I,. A.: Radiog~ams de Card. 1: 216, 1934.

of the

Heart.

in Systole

am-i

Disstole.

Rev.

Argentina

A device is doscribcd to obtain radiographs of the heart during either systole or diastole. The electrical disturbance caused by the heart sounds are amplified in a microphone adapted to the precordial region, starts the x-ray machine. Mechanisms are provided which ailow an accurate adjustment so as to take the radiograph at any desired moment after the beginning of cardiac activity during either systole or diastole. When the heart sounds are modified in their number or quality, the central arterial pulse can hc substituted to start the x-ray machine. A characteristic feature of this method consists in the actual mechanism of starting the x-rays which is very closely associated with cardiac activity (heart sounds or central pulse) thus avoiding the several causes of error that are encountered in following other procedures so far described. Paul,

John

R.;

Harrison,

Social Incidence

Elizabeth

of Rheumatic

R.;

Salinger,

Heart Disease.

R.; Am.

and DeFomst,

G. IL.:

.I’. M.

301, 1934.

SC. 188:

The

In an attempt to determine the influence which poverty and urban environments may play as predisposing factors in rheumatic fever, the incidence of rheumatic heart disease has been determined in groups of children between the ages of five and eighteen years, attending urban and suburban schools in and about the city of New Haven. Data from the routine examinations of 5,758 public school children performed by school physicians suggested that systolic murmurs, presumably of rheumatic origin, were roughly 1.5 times as prevalent among children from the poorer districts than in those from the better districts of the city. From the authors’ examination of 758 urban children, the incidence of rheumatic heart disease in a single large public school in one of the poorest districts of the city was found to be 48.1 per 1,000. This proved to be 1.5 times as high as that found in a public school in one of the better districts .of the city, but 8 times as high as that found among a smaller group of pupils from urban private schools who came from the best districts of the city. The average incidence of rheumatic heart disease among pupils attending two urban public schools was about twice that recorded among pupils of a similar age group who attended suburban and rural public schools.