20 



Scientific Proceedings (ioi). 



individuals with chronic heart disease. All patients in this 

 group have been carefully selected because they were suffering 

 primarily from a failure of the heart to maintain an adequate 

 circulation. They have been free as far as could be determined 

 from any vascular or renal disease. For the most part they were 

 young patients with chronic rheumatic myocarditis and valvulitis. 



In some a normal cardiac mechanism was present, as deter- 

 mined by the electrocardiograph. In others auricular fibrillation 

 usually associated with mitral stenosis was found. Moribund 

 patients and patients with a marked degree of venous stasis and 

 edema have not been included. 



Samples of the arterial and venous blood were obtained at 

 the same operation; immediately centrifuged, and the total CO2 

 content of the separated plasma determined directly. In all 

 cases the blood was obtained while the patient was at rest in 

 bed. The results are presented in the accompanying table. 



The Total Carbonate Content of the Arterial and Venous Plasma in 

 Patients with Chronic Heart Disease. 



COi reduced to o°-76o mm. in 100 c.c. plasma. 



Arterial 



Venous 



Arterial 



Venous 



c.c. 



c.c. 



c.c. 



c.c. 



42.8 



50.6 



32.0 



44- S 



33-7 



37-3 



41.6 



48.4 



38.2 



50.3 



48.5 



54-2 



47-6 



52.5 



39-7 



44-6 



46.9 



50.6 



51.0 



63.0 



It is seen that both the arterial and venous plasma have 

 a total C0 2 lower than that found in normal individuals. The 

 arterial values for CO2 show wider variation and the discrepancy 

 between the CO2 of the arterial and venous plasma is more marked 

 in heart cases than in normal individuals. These differences are 

 attributed to the varying degrees of cardiac efficiency in the 

 heart patients. 



In the type of cases studied there has been a certain relation 

 between the integrity of the circulation and the level of C0 2 in the 

 plasma. The more dyspneic the patient the lower has been the 

 CO2 in the arterial plasma. The following case will serve as an 

 example: A patient walked into the hospital complaining of 



