DISEASES OF 71/ E HEART. 



lO'J 



li LOWING. HEART SOUNDS. 



PV-\v!ng murmur 

 before the first 

 sound. 



Blowing murmur 

 with the first sound. 



Strongest toward the base of 

 the heart. Heard along the . 

 large arteries. 



Strongest toward the left of 

 the heart. Not heard over the 

 great arteries. 



I 



Narrowing of the 



auriculo - ventricular 



■I. orifice. Clots or 



growths on the 



valves. 



N.arrowing of the 

 Oldening of the aorta. 



Narrowing of the 

 pulmonary artery, or 

 imperfect action of 

 the auriculo - ventri- 

 cular valves. 



Double rushing sound heard [ Imperfect action 

 over the great arteries at each J of the valves at the 

 heart-beat. I opening of the aorta. 



{Double rushing sound in the f 

 . , , , . , I Aneurism (dilata- 



arteries with each beat of the- 

 , tion) of the aorta, 



heart. (^ ' 



Besides these the second sound may be doubled in hyper- 

 trophy of one ventricle of the heart 



The sounds are hke whispered who, awe, ss, or r, very low 

 but exceedingly characteristic 



Other Symptoms. — Besides the fever attendant on inflam- 

 matory affections there are characteristic phenomena present 

 in the chronic form of heart-disease. These are shown at rest 

 or only developed under exercise. There are habitually cold 

 extremities, dropsies in the limbs, and beneath and within the 

 chest and abdomen, difficult breathing, especially during exer- 

 tion, unsteady gait when hurried, vertigo, partial paralysis, or 

 cramps of the limbs. In most cases there is sluggishness, 

 dulness, and a tendency to lay on fat. Patients may be lively 

 when at rest, but flag at work, and are liable to sudden fainting 

 or death. 



