Carl Wegelius

Atrial Septal Defects in Children An Angiocardiographic Study

Atrial septal defects in children have been examined with an angiocardiographic technic which permits conclusions concerning the dynamics of the heart. This method combines direct synchronous biplane photography at a speed of 10 to 12 pictures per second with simultaneous electrocardiograms.

The Dynamics of the Heart in Complete A-V Block An Angiocardiographic Study

The conduction disturbances in atrioventricular block are well known from numerous electrocardiographic studies, but the effect on the heart work, especially on the individual chambers, could not be recorded before the introduction of visualization of the heart chambers by angiocardiography. Rapid biplane angiocardiography with simultaneous electrocardiographic yields information on cardiac dynamics not available by procedures with a purely static anatomic perception.

Rntgenologische Lungenbefunde beim ersten Atemzug des Neugeborenen

ZusammenfassungDas Geschehen des ersten Atemzuges wurde mit Kineröntgenfilm bei 17 und mit Filmwechsler bei 34 Neugeborenen untersucht. Dabei zeigte sich, daß die primäre Aeration gewöhnlich unten in der linken Lunge anfängt. Vermutlich beruht das auf der größeren Beweglichkeit der linken Zwerchfellhälfte. Zwischen Geburt und Aeration liegt ein Intervall von verschieden langer Dauer. Wenn die Luft aber in Bewegung gekommen ist, so verbreitet sie sich explosionsartig über die Lungenfelder. Die Aeration scheint vor allem durch eine starke Kontraktion des Zwerchfells bewirkt zu sein, obwohl noch weitere, bisher weniger bekannte Umstände, wie Veränderungen im Lungenblutkreislauf, daran beteiligt sein dürften.Das Geschehen des ersten Atemzuges wurde mit Kinerontgenfilm bei 17 und mit Filmwechsler bei 34 Neugeborenen untersucht. Dabei zeigte sich, das die primare Aeration gewohnlich unten in der linken Lunge anfangt. Vermutlich beruht das auf der groseren Beweglichkeit der linken Zwerchfellhalfte. Zwischen Geburt und Aeration liegt ein Intervall von verschieden langer Dauer. Wenn die Luft aber in Bewegung gekommen ist, so verbreitet sie sich explosionsartig uber die Lungenfelder. Die Aeration scheint vor allem durch eine starke Kontraktion des Zwerchfells bewirkt zu sein, obwohl noch weitere, bisher weniger bekannte Umstande, wie Veranderungen im Lungenblutkreislauf, daran beteiligt sein durften.

CAVAL REFLUXES IN ANGIOCARDIOGRAPHY AND THE DYNAMICS OF THE RIGHT ATRIUM

During the past few years angiocardiography has become one of the routine methods in the investigation of congenital heart disease. The development of the technique has increased its diagnostic value so that it offers a method of judging not only the anatomical, but also the pathophysiological aspects of a heart disease. This paper deals with a problem often met with in angiocardiography, i.e. the regurgitation of dye from the right atrium into the vene cavx and their proximal branches, and its relation to the function of the right atrium. This phenomenon, which occurs especially in children, has sometimes been thought to have a special diagnostic value. Up to the present, however, no detailed investigation of the mechanism of this reflux appears to have been carried out.

Differential Analysis of Opacification in Angiocardiography A Graphic Interpretation of Cardiac Function

Each individual exposure in an angiocardiogram gives a picture of the arrested motion of the heart in successive stages of opacification. By combining these isolated views in a graph, a continuous dynamic process can be visualized. The chambers of the heart can be analyzed separately, and by correlating the opacification in the various chambers, the function of the heart as a whole can be studied.

THE DIAGNOSIS OF CARDIAC SHUNTS BY INTRAVENOUS ANGIOCARDIOGRAPHY

In the study of cardiodynamics, the role of specific radiographic techniques is assuming increasing significance. The development of kymography and electrokymography results from the effort to record the deviations in individual portions of the cardiac silhouette as correlated with the electrocardiogram. However, the movements of the silhouette fail to give an accurate representation of the work of the heart, for, to a large extent, the activity actually takes place within the heart and cannot be visualized from outside. Angiocardiography is, therefore, a step forward towards clarification of the total mechanical functioning of the heart. It represents a distinct addition to the armamentarium of cardiophysiology, because by this means successive contrast filling of the individual chambers and great vessels determines variations in function as well as outline. Henceforth these alterations in function, instead of being a final diagnosis, may be used to facilitate the diagnosis of specific congenital and acquired heart disease. The internal working of the heart and the individual chambers can best be illustrated by the study of shunts; here all action takes place within the walls of the vascular apparatus and cannot be analyzed by the most perfect representation of the movements of the cardiac silhouette. Angiocardiography is another milestone along the road to better understanding of the function of this vital complex mechanism. The normal findings in the right and left anterior oblique views are shown in Fig. 1 for comparison with the subsequent figures demonstrating shunts. Technique. The angiocardiograms reported here were made on infants and small children under comparable and reproducible conditions. A 2 5 per cent solution of avertin, 0-1 ml. per kilogram of body weight, was used for basal aneesthesia. The radiograms were taken simultaneously in both the right and the left anterior oblique projections at a speed of 10 to 12 exposures a second in each projection. An automatic marker recorded the exact moment of exposure of each film on the electrocardiogram which was taken during the angiocardiogram. The contrast medium was 70 per cent umbradil (Astra); 1 to 15 ml. per kg. of body weight was injected rapidly through the malleolar vein in infants and through the antecubital vein of the small children.

The dynamics of the heart: Observations by angiocardiography

Summary The diagnostic importance for both physiological and pathophysiological investigations of recording and evaluating the heart dynamics, visualized by angiocardiography, is discussed. A procedure which fulfils the requirements of a satisfactory recording of the cardiovascular dynamics is described. Its main characteristics are direct radiography in two planes synchronously at a speed of 10 pairs of pictures per second and simultaneous E.C.G. tracings with marking of the exposures.

Physiologische Beobachtungen über die experimentelle Hypothermie beim Hunde

Im Rahmen der zugelassenen Zeit wird sich unsere Mitteilung auf einige zirkulationsphysiologische Beobachtungen beschranken. Die experimentell hervorgerufene Hypothermie provoziert bei allen warmblutigen Nichtwinterschlafern einzigartige, gewaltige Umstellungen der Zirkulation, die klinisch auserst bedeutungsvoll sind. Die hier von uns erwahnten Versuchsresultate sind beim Hunde erzielt worden, sie scheinen aber durchgehend auch fur andere nichtwinterschlafende Warmbluter charakteristisch zu sein.

Changes in the heart silhouette as studied by angiocardiography

Summary The authors investigated the part played by the left auricle and its appendix in the formation of the left cardiac border in the frontal projection. They examined five children aged 18 days to 5 years, with normal E.C.G.s and angiocardiograms and concluded that the left auricle becomes marginal during diastole, whilst in systole it takes no part in the formation of the cardiac silhouette. The phase of the cardiac cycle is the determining factor. Finally, in one case with proved mitral stenosis and auricular dilatation they demonstrated that the left auricular appendix is marginal in both systole and diastole.