Observations upon a curious and not uncommon form of extreme acceleration of the auricle : "auricular flutter" / by Thomas Lewis.
- Thomas Lewis
- Date:
- [1912]
Licence: Public Domain Mark
Credit: Observations upon a curious and not uncommon form of extreme acceleration of the auricle : "auricular flutter" / by Thomas Lewis. Source: Wellcome Collection.
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![Condition, April the 19th, 1912. A stout woman, who showed a trace of cyanosis. Breathlessness was obvious while she lay flat in bed. There was no dropsy. The liver dulness came an inch below the costal margin; the organ was readily felt, and there was tenderness to pressure over it. The urine was normal. During her stay she had fever for a few days (97-101 degrees Fahr.) and the ankle and wrist joints became swollen and paintul. The limits of cardiac dulness lay 2 and 5 inches to the right and left of the mid-sternal line. A short systolic murmur was heard at the apex. The heart sounds were otherwise normal. At the time of observation, she was upon thirty minims of the tincture of digitalis and she had had in all seven and a half drachms of this drug or its equivalent. The ventricular rate was usually 160, though there were periods of irregular and slower action from time to time. The rate of the heart beat was not affected by posture. The observations upon the heart mechanism and the course of the condition are summarised in the accompanying table. DATE eae oR Vs Ratse.| As Rate. | Druas. REMARKS. 3-4-12 | Pulse counts 160-118 Tinct. Date of admission. -160 Digit. 19-4-12 | Electrocardiographic 156 312 Tinct. Chiefly 2:1. Also irregu- Digit. lar periods of 2: 1 mM. xxx and 3:1. 20-4-12 | Pulse counts. 120-158 Tih KS Usually regular; some to daily till irregular periods. Fever 25-4-12 the 2nd 101° and rheumatism of foot. Nausea. 2-5-12 | Electrocardiographic | 123-160 320 m. xlv. Chiefly 2: 1; also irregular periods of 2: ] and 3: 1. 4-5-12 | Electrocardiographic 8] 324 m. 1x 4: ] heart-block ; regular. 6-5-12 | Electrocardiographic 7? m. Ix Fibrillation of the auricles. (Total Digitalis stopped. dr. xviii) 9-5-12 | Pulse counts 72-96 None Fibrillation still. 19-5-12 | Pulse counts 88-92 None Fibrillation still. 12-5-12 | Pulse counts 82-90 None Pulse became regular. Probably returned to normal rhythm. 13-5-12 | Electrocardiographic 81 81 None Pulse regular, normal rhythm. 15-5-12*| Pulse counts 12-92 None Pulse regular, normal rhythm. 29-5-12 | Electrocardiographic 108 108 None Pulse regular, normal rhythm. 1-6-12 | Electrocardiographic 9] 91 None Pulse regular, normal rhythm. 10-6-12 | Pulse counts 70-88 | : | Momma sey Hain eel, The breath lessness has gone. The liver has receded beneath the ribs, There is no pain or palpitation. She feels much stronger and her colour is natural. 10-6-12 Discharged from hospital. 7-8-12 | Electrocardiographic 80-90 80-90 None Normal rhythm. Rate rise to 101 on standing and falls to 80 lying. Slight dropsy of ankles and alittle shortness of breath. * On the 15th of May, in the early morning, she had a slight stroke ; consciousness was not lost but the left half of the face and left arm became paralysed and speech was impaired, The paresis cleared up entirely during the course of the next few days,](https://iiif.wellcomecollection.org/image/b3343069x_0005.jp2/full/800%2C/0/default.jpg)
