C. Robert E. Wells

Hemodynamic findings in acuteglomerulonephritis

Eleven children with acute glomerulonephritis and roentgenographic evidence of cardiomegaly and pulmonary vascular congestion were studied by means of cardiac catheterization, hematologic investigations, and renal biopsy. The findings of elevated left atrial pressure, elevated cardiac index, and low arteriovenous oxygen difference indicate that the central venous congestion present in this disease is not on the basis of myocardial failure. This is confirmed by the absence of effect of administration of digoxin. There is some evidence to indicate that sodium nitrite may exert a favorable hemodynamic effect in patients with acute glomerulonephritis. An unexplained finding was a shortened erythrocyte survival time in 3 of 10 patients.

Experience in secondary screening of cardiac suspects of school age.

Summary 1. Four thousand, five hundred ninety-nine public and parochial school children in the city of Philadelphia who were arbitrarily selected as cardiac suspects have been subjected to cardiac re-evaluation by a rapid method of secondary screening. 2. The results of these re-evaluations are presented and compared with the cardiac diagnoses from the primary examination. Of the total number of children examined, roughly 85 per cent were found to have no evidence of heart disease, 10 per cent had characteristic physical findings of either congenital or rheumatic heart disease, and in 5 per cent it was impossible to make a definite diagnosis by the method of examination employed. 3. Among the 1,464 children initially selected for re-examination because of real or questionable heart disease, the diagnosis of organic heart disease was confirmed in only 25.9 per cent, demonstrating that cardiac disease had been overdiagnosed in the course of the initial routine physical examinations. 4. The methods and criteria used in this program of secondary screening of cardiac suspects, as well as the limitations and advantages of such a program, are briefly discussed.

The transmission of systolic murmurs from the pulmonary artery into the left atrium

Abstract Systolic murmurs may be transmitted directly through adjacent walls from the pulmonary artery to the left atrial appendage. Thus, the recording of a systolic murmur in the left atrial appendage suggests its origin in the pulmonary artery. It is hoped that this observation will further the understanding of intracardiac sounds.

The transient nature ofWolff-Parkinson-White anomaly in childhood

Summary The electrocardiographic findings in 31pediatric patients who had the WPW anomaly of conduction on at least one occasion have been reviewed. In 39 per cent of these individuals the abnormal conduction mechanism was of a transient or intermittent nature. Intermittency in electrocardiographic configuration occurred most commonly in infancy. A favorable prognosis for pediatric patients with this electrocardiographic abnormality should be offered.