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For the purposes of discussion, the prognostic factors in diseases of the heart may be conveniently divided into three groups:
The condition of the cardiac valves.
The condition of the capillary and venous circulation.
The condition of the muscle of the heart and of the muscular coat of the arteries—especially of the arterioles.
Of the abnormalities of the mitral valve the obstructive lesion is more serious than that of insufficiency, provided the myocardium is in fair condition; a double mitral lesion is more serious than either single one. Obstruction at this orifice is serious in two ways; if it is due to vegetations on the free edges of the valves or on the margin of the orifice at place of attachment of the valves, these vegetations may be swept off by the blood current and form infarct of the brain with all its serious consequences; if the obstruction is due
ROCHESTER D. PROGNOSIS AND THERAPEUTIC INDICATIONS IN CHRONIC DISEASES OF THE HEART. JAMA. 1897;XXVIII(26):1207–1209. doi:10.1001/jama.1897.02440260001001
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