William B. Kountz

The heart in emphysema

Abstract From these observations it appears (1) that the heart is affected in the majority of patients with emphysema; (2) that the lesion, cardiac hypertrophy, with dilatation of the right ventricle when advanced, may produce symptoms, but probably has no clinical reflection in its earlier stages; (3) that the cause of the left ventricular hypertrophy remains, as yet, undetermined; (4) that there is experimental evidence which indicates that the right ventricular dilatation and hypertrophy occur chiefly in the earlier stage of emphysema, when the lungs are in the process of distention, rather than later as generally believed.

The effect of position of the heart on the electrocardiogram

Abstract Eight cases of revived human heart in which a reasonably normal type of electrocardiographic curve was obtained have been studied with regard to both the localization of extrasystoles and bundle-branch block. With the heart in normal position it is found that the extrasystoles were similar to those described by Barker, Macleod and Alexander. The right and left bundles were cut in five instances, and the results indicate with the heart in normal position that a lesion of the right bundle is characterized by a deflection that is downward in Lead I and upward in Lead III. When the left bundle was cut with the heart in normal position or with left axis deviation, the electrocardiographic curve was characterized by an upward deflection of the complex in Lead I and a downward deflection in Lead III. Changes in position of the heart greatly modify the character of the curves of both extrasystoles and bundle-branch block. Shifting of the human heart to the left in one instance gave a right axis deviation (old terminology); shifting of it to the right gave a left axis deviation. Rotation of the heart also causes variation in the electrical axis.

Effect of asphyxia and of anoxemia on the electrocardiogram

Abstract Perfusion of coronary arteries of the dog with asphyxial blood produces changes in the electrocardiogram similar to but more marked than those produced by clamping the coronary arteries. These changes in the electrocardiogram are found to be comparable to those observed in coronary diseases in the human heart. Neither anoxemia nor excess of CO 2 separately produces the changes observed in asphyxia. Administration of cyanide, producing the severest form of anoxemia, also fails to produce these changes. It is suggested that the change in the R-T segment typical of experimental asphyxia of the heart and probably of human coronary disease is due to a high concentration of locally produced metabolites. Perfusion with anoxemic blood tends to lower or invert the T-waves of the electrocardiogram in different leads depending upon which ventricle is affected. Excess of CO 2 increases the size of the T-wave in all leads and causes a development of ventricular foci. 10

REVIVAL OF HUMAN HEARTS

Excerpt Attempts to develop a method which would make possible studies on the revived human heart have been made during the past six years. A number of references to such work may be found in the l...

Revitalization of tissue and nutrition in older individuals.

Excerpt It has long been considered that changes occurring in the body due to aging are irreversible. If such were a clearly established fact, the field of geriatric medicine would be greatly limit...

DEFORMITIES OF THE THORACIC SPINE AS A CAUSE OF ANGINOID PAIN

Excerpt During the past 25 years considerable attention has been focused on the possibility of dorsal root pain simulating attacks of angina pectoris, and many suggestions concerning the differenti...

The Effect of Pitressin (Vaso-pressin) upon the Heart

It has been pointed out by one of us 1 that pitressin (Vaso-pressin) caused a marked drop in blood pressure and decreased pulse rate in the unanesthetized dog. The decreased pulse rate we then believed to be of vagal origin. The present work is a continuation of these earlier experiments. The effect of the drug upon the heart was noted by recording the electrical potential changes in the action current by the string galvanometer in leads I and III, although usually only the latter lead was employed. Unanesthetized dogs were used. The pitressin was injected intravenously in small doses 0.1 to 0.5 cc. and in some cases followed by the injection of atropine sulphate in doses of 0.2 mgm. or more per kilo. In other experiments the atropine was injected intravenously before the pitressin and other experiments were performed on animals in which the vagi had been severed under ether anesthesia a sufficient time earlier for the animals to have recovered. In a series of unanesthetized dogs the effect of pitressin upon the blood pressure and pulse rate was studied by means either of a mercury monometer or of a membrane monometer. The pulse rate was counted before, during and following the fall in blood pressure. Other conditions were similar to the above described experiments. The effect of pitressin upon coronary flow was studied in excised perfused rabbits hearts. Results. The electrocardiographic studies in the normal unanesthetized dog shows the heart slowed, 10 to 15 seconds after the injection of pitressin. This slowing was quickly followed by an acceleration which was subsequently followed by marked slowing of the heart, which persisted for several minutes. During the period of excessive slowing high branching of the T-wave occurred with a marked increase in the height of the wave.

The use of the cathode ray for recording heart sounds and vibrations III. Total cardiac vibrations in one hundred normal subjects

Abstract The usual study of heart sounds is limited to the recording of the sound vibrations only, with little attention to other vibrations produced by the beating heart. In this investigation, all of the cardiac vibrations at the usual auscultation areas in 100 normal young adults were recorded by means of a cathode-ray vibrocardiograph. The intensity and duration of the first and second sound vibration groups were studied in relation to the length of the systolic and diastolic phases of the cardiac cycle. With this method, murmurs are reproduced at the intensity with which they occur, and, if faint, may appear diminutive in comparison with the deflections which represent the heart sounds. Most interesting are the low-frequency vibrations, below the auditory level, which occur in systole and diastole and possibly indicate myocardial motion alone.

Observations on the effect of tourniquets on acute cardiac crises, normal subjects, and chronic heart failure☆

Abstract 1. 1. The application of tourniquets to the extremities of patients with paroxysmal left ventricular failure usually results in dramatic improvement. 2. 2. This procedure was further investigated by means of an instrument which inflated and deflated cuffs, placed on the arms and thighs, in rotation. The effects on venous and arterial pressure, on cardiac size and contraction, and on cardiac output were observed in normal persons and in patients with heart disease. In both groups, rhythmic inflation of the cuffs caused a fall in venous pressure, diminution of cardiac contraction, and a fall in cardiac output; the arterial pressures were essentially unchanged. In normal persons some enlargement of the heart occurred during rhythmic constriction of the extremities; in patients with hypertensive heart disease the size of the heart usually remained unchanged, but, in two instances, the heart diminished slightly in size. A suggestion as to the cause of these phenomena is offered. 3. 3. It is suggested that this procedure may be useful in the treatment of acute myocardial infarction, as well as in paroxysmal cardiac dyspnea. It appears to be of no benefit in right ventricular failure.

Serum cholesterol, phospholipid and lipoprotein levels in elderly male subjects.

Summary The cholesterol, phospholipid and Sf 12-20 levels in the blood serum were determined in a number of elderly subjects all over the age of 52. In these age groups there was a slight decrease in Sf level with age and a good correlation between the Sf level and the cholesterol level. The phospholipid level was found to vary linearly with the cholesterol level.