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In simple chronic renal diseases the heart first normally hypertrophies to overcome the increased blood tension and increased resistance. The principal causes of this degeneration are normal old age, or premature age caused by various conditions. In other words, anything which hastens arteriosclerosis will cause myocardial degeneration.
Pulsus alternans, except when it is very temporary, Gordinier finds to be of grave import, as it shows myocardial degeneration, and most patients will die from cardiac insufficiency in less than three years from the onset of the disturbance.
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