Seventy per cent of the cases studied showed signs two weeks is almost certain. With a longer of structural heart disease. The symptoms usually were not severe. attack or where the heart was already in difficulty all the signs and symptoms of congestive heart failure were seen. Low Master, Arthur M.: SC. 181: 211, 1931.
In 107 patients a study was made of low voltage T-waves in which the amplitude In 12 patients that were examined postin any lead was not more than 1 mm. mortem all showed definite myocardial or pericardial damage. Another group of 12 Eleven died with typical myocardial patients died but no autopsy was performed. failure and 1 of pulmonary tuberculosis. Altogether, there were 89 hospital patients with flat T-waves, the mortality among those with degenerative cardiovsscular disease was at least 44 per cent during the course of a three to four years’ investigation. Acute rheumatic infection of the myocardium or pericardium often produces a flat T-wave and in the progression of the disease the T-wave ma.y become inverted or if the patient recovers, it will become upright. The rheumatic cardiac patient The sowith a flat T-wave is acutely ill and is probably always a bed patient. called coronary T-wave or cove-plane T-wave that is customarily associated with coronary artery occlusion may appear in a patient with rheumatic pericarditis. Suggestive evidence is presented tha,t pericarditis alone without disease of the underlying myocardium, may cause a flat T-wave. When a flat T-wave appears in the course of other diseases it seems to indicate a very severe form of illness. These T-waves are practically always transitory becoming inverted as the myocardial or pericardial damage spreads and increasing in amplitude on cure or improvement.
John, and Bedford, Attacks
Electrocardiographic 1: 15, 1931.
In 5 patients with attacks of angina pectoris electrocardiograms taken during short paroxysms show definite and transitory changes in the ventricular deflections. There was a depression of R-T and a diminution in the amplitude or inversion of the T-waves in one or more leads, changes closely resembling though not so pronounced as those which follow cardiac infarction in the early stages. It is surely significant that both transient angina1 pain and cardiac infarction can affect the electrocardiogram in a similar manner; and it seems reasonable to infer that the mechanism underlying this electrocardiographic change is essentially the same in both cases-an ischemia of a part of the cardiac muscle. The authors do not suppose that the electrocardiogram is always modified during short angina1 attacks but their evidence suggests that it is modified in a proportion of cases.
1, 1931. A group of eight cases is reported as exemplifying mild forms of coronary The records of these patients appear to define a distinct clinical group thrombosis. characterized by the relative youth of the patients and rapid rate of recovery both subjective and objective. One of the eight patients died of a second attack; one patient had a second occlusion one year after the first; another has had two later of function has been complete in two patients; two of the attacks ; restoration patients are free from symptoms on restricted activity; three have symptoms even with carefully regulated lives; two still complain of pain in the heart and one of dyspnea on effort.