SPECIAL CLINICAL EXAMINATION. 89 



Acute endocarditis. Not very common. Fever, greatly ac- 

 •celerated heart's action, irregular pulse, intermittent, very small. 

 "Heart sounds are at tirst normal, later systolic bruit. Dyspnea. 

 General condition altered. Prognosis unfavorable. 



Valvular disease, chronic endocarditis. Caused by a chronic 

 valvular endocarditis which leads to an atrophy of the valves 

 (insufficiency) or to a narrowing of the orifices (stenosis). Fol- 

 lowing valvular failure a hypertrophy of the ventricle always takes 

 place; in disease of the semilunar valves the left ventricle, in 

 defects of the mitral valve a hypertrophy of the right ventricle. 

 The hypertrophy of the ventricle, which is combined with dila- 

 tation, is compensatory. 



Bicuspid (Mitral) insufficiency. Most common form 

 of heart disease in dogs and horses. Pulse small, irregular. Sys- 

 tolic bruit. Diastolic sound clear, loud. Dyspnea on exercise. 



Stenosis of the bicuspid (Mitral) valves. Rare 

 when unattended with insufficiency; an uncommon lesion com- 

 pared with insufficiency. Pulse small and very weak. Diastolic 

 and pre-systolic bruits. Great dyspnea. 



Insufficiency of the tricuspid valves. Rarely 

 primary in the horse, mostly secondary to diseases involving the 

 left ventricle, leading to hypertrophy of the right heart. In the 

 ox frequently primary. Systolic bruits, venous congestion, venous 

 pulse. 



Stenosis of the tricuspid valves. Happens only 

 in the o.x and is then combined with insufficiency. Diastolic bruits, 

 great venous congestion, dyspnea. 



Insufficiency of the aortic semilunar valves. 

 Full, strong, hopping pulse, pulsation in peripheral arteries. 

 Diastolic bruit. Hypertrophy of the left heart. 



Stenosis of the aorta. Mostly combined with insuf- 

 ficiency. Harsh systolic bruit. Long-drawn-out, slow, small pulse 

 (28-32 in the horse). Hypertrophy, attacks of vertigo during exer- 

 cise (work). 



Valvular diseases of the pulmonary artery 

 are very rare. 



Termination of all valvular diseases. In 

 chronic heart diseases the dilatation of the ventricle is followed by 

 a relative insufficiency of the valves. Semilunar defects lead to 

 a relative insufficiency of bicuspids; bicuspid defects to a relative 

 insufficiency of the tricuspids. The special diagnosis of the pri- 

 mary lesion is then very difficult. As sequela, finally, the follow- 

 ing symptoms appear: small, irregular pulse, systolic and diastolic 

 bruits, congestion of veins, venous pulse, edemas, dyspnea, 

 albuminuria, dropsy, attacks of vertigo, emaciation and great 

 weakness. 



Pericarditis. Mostly a symptom of other diseases. Moderate 

 fever, congestion of mucous membranes. Pulse rapid, heart's 

 beat weak or imperceptible, zone of cardiac dullness increased, 

 pericardial (frictional) bruits, which disappear when fluid exudate 



