Clinical disorders of the heart beat : a handbook for practitioners and students / by Thomas Lewis.

  • Thomas Lewis
Date:
1915
Catalogue details

Licence: In copyright

Credit: Clinical disorders of the heart beat : a handbook for practitioners and students / by Thomas Lewis. Source: Wellcome Collection.

    23/136 page 7
    Halved pidse rate. When the ventricle beats at twice the pulse rate, the disorder is due to premature contractions in all but the rarest instances. Alternation has been known to occasion halving, the Aveak alternate beats failing to reach the wrist ; but this condition is of great rarity and, when it occurs, is very transient. The two are readily differentiated, for in the first instance the ventricular beats are coupled while in the last they appear regularly. When sudden and exact halving of pulse rate is noted and the ventricular rate is halved simultaneously, the disorder is the result of heart-block. A grossly irregular pulse in which there is hopeless jumbling of stronger pulsations with quick runs of almost imperceptible beats, and in which the lengths of intervening pauses are constantly varying, is due to auricular fibrillation. A mild grade of irregularity which persists, which is not related to respiration even when the breathing is deepened and in which no definite sequence of events can be determined, is also due to auricular fibrillation in most cases. A similar irregularity, which shows relations to respiration, is a sinus arrhythmia. In the preceding paragraphs the method of procedure at the bedside is briefly stated, and an acquaintance with the few rules which I have given will enable the practitioner to identify a very large number of the disorderly forms of heart action with which he meets. But where the reader is in doubt, or when he requires more explicit information, in regard to the arrangements of the beats, or in respect of the management of the case in which the disorder is discovered, he may refer to the more detailed descriptions contained in the following chapters.
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