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Updated: June 8, 2025
The foremost section, which is turned towards the ventral side, and from which the aortic arches rise, reproduces the arterial bulb of the Selachii. The heart of the human embryo is now a complete fish-heart. Transverse section of the back of the head of a chick-embryo, forty hours old.
The physical sign is a systolic blow at the second intercostal space on the left; but as just stated, such a murmur must surely be dissociated from an aortic murmur if found to develop after babyhood, and it should also be diagnosed from the frequently occurring hemic, basic and systolic murmurs; that is, if signs of pulmonary lesions are not heard soon after birth or in early babyhood, the diagnosis of pulmonary defects can be made only by exclusion.
Presently the tube bends into the shape of an S, and turns spirally on an imaginary axis in such a way that the hind part comes to lie on the dorsal surface of the fore part. The united vitelline veins open into the posterior end. From the anterior end spring the aortic arches.
In aortic regurgitation this low diastolic pressure is constantly in evidence, and, if the systolic pressure is not below normal, does not signify that the circulation is insufficient. If the systolic pressure is not very low but the diastolic is high, vasodilator drugs, by lowering the diastolic and increasing the pulse pressure, are often of benefit.
Aortic disease, on the other hand, from the very fact of their strenuous life and occupations, is nearly three times more frequent in men than in women. If a chronic endocarditis has followed an acute condition, some slight permanent papillomas or warty growths may he left from the healed granulating or ulcerated surfaces.
I have grave doubts as to my mitral valve, if you would be so very good. The aortic I may rely upon, but I should value your opinion upon the mitral." I listened to his heart, as requested, but was unable to find anything amiss, save indeed that he was in an ecstasy of fear, for he shivered from head to foot. "It appears to be normal," I said. "You have no cause for uneasiness."
This part of the heart, being the strongest muscular portion, is the part most adapted to hypertrophy, and the hypertrophy with this lesion is often enormous. For a long time this large muscular section of the heart can overcome all difficulties of the aortic insufficiency.
This lesion may allow a patient to live for years, provided no other serious disturbance of the heart occurs, such as myocarditis or coronary disease; but sooner or later, with the failing force of the blood flow and the lessened aortic pressure, slight attacks of anemia of the brain occur, causing syncope or fainting. Also, sooner or later these patients have little cardiac pains.
Valvular disease at the aortic orifice is much less common than at the mitral orifice, and while stenosis or obstruction is less common from rheumatism or acute inflammatory endocarditis than is insufficiency of this valve, a narrowing or at least the clinical sign of narrowing, denoted by a systolic blow at the base of the heart over the aortic opening, is in arteriosclerosis and old age of frequent occurrence.
Statistics have shown that the valves of the left side of the heart are diseased nearly twenty times as frequently as those of the right side of the heart. They also show that the mitral valve is diseased more than one and one-half times as frequently as the aortic valve.
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