In order to avoid confusion in discussion of the group of cases that I am reporting, it is necessary to bear in mind a precise definition of the signs of heart failure of the congestive type.
Whatever may be the complete pathologic physiology in congestive heart failure, the physical signs by which we can recognize it clinically are few and definite. They depend on actual venous congestion from a failure of the heart to pump away the blood as fast as it receives it, and are, in differing proportions in individual cases: (1) from congestion in the pulmonary veins; diminshed vital capacity; orthopnea; râles, particularly in the dependent portions of the lungs; cough, perhaps productive, perhaps hemoptysis; (2) from congestion of the systemic veins; liver enlargement, with possibly tenderness and pain. There may be an accompanying demonstrable congestion of the neck veins. Demonstrable general edema often comes late in the
HAMILTON BE. HEART FAILURE OF THE CONGESTIVE TYPE CAUSED BY HYPERTHYROIDISM. JAMA. 1924;83(6):405–410. doi:10.1001/jama.1924.02660060009003
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