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May 1928


Arch Intern Med (Chic). 1928;41(5):667-682. doi:10.1001/archinte.1928.00130170054007

The differentiation of the enlarged heart from the heart of normal size is the most important single factor in determining the presence or absence of organic heart disease. With the exception of mitral stenosis and atrophic myocarditis, all but the rarest types of organic heart disease lead to hypertrophy of the ventricles. Except in rare instances, the left ventricle is most affected in the types with which the physician has to deal. This chamber is most affected in double mitral disease, in aortic disease, in adherent pericardium, in arterial hypertension and in myocardial degeneration associated with syphilitic or other types of aortitis and arterial injury. The greatly hypertrophied heart in advanced organic disease is easily recognized by the usual methods of physical examination, but there is need for more accurate differentiation of the hearts that are less abnormal and associated with an earlier stage in the pathologic process. This is