[Report 1933] / School Medical Officer of Health, West Bromwich.
- West Bromwich (England). Council.
- Date:
- 1933
Licence: Attribution 4.0 International (CC BY 4.0)
Credit: [Report 1933] / School Medical Officer of Health, West Bromwich. Source: Wellcome Collection.
34/46 page 32
![XIX.—SPECIAL INQUIRIES. RADIOLOGY AN]) HEART DISEASE IN CHILDREN. By E. Hughes, M.B., Ch.B., D.P.H., Assistant School Medical Officer. During the last twelve months an attempt has been made to investigate the value ot radiology in the diagnosis of heart disease amongst the school children of the Borough. Clinicians are aware that it is extremely difficult to gauge the exact size and shape of the heart by the routine methods of percussion and palpation. Owing to the fact that the heart lies obliquely within the chest cavity and also owing to its intrinsic movements occasioned by pulsation and respiration, the old conception of it as a hat surface applied to the front of the chest wall is, obviously, erroneous. It has long been recognised that the so-called areas of superficial and deep cardiac dullness may be quite misleading. In children it is found most difficult to gauge the exact size of the heart or, what is more important, to tell when it is slightly enlarged. The recognition of gross degrees of cardiac enlargement is fairly simple but there is need for more accurate differentiation of the hearts that are less abnormal and associated with an earlier stage of the pathological process. This is the period when there is a possibility of retarding any advance of the condition. Many writers, especially on the Continent and in America, have studied the value of X-rays in heart disease and they claim that it gives us the information which we seek. They have elaborated a series of measurements by which slight degrees of cardiac enlargement may be detected. The three most important measurements are: (1) the transverse diameter, or width of the heart shadow. (2) the area of the frontal heart silhouette. (3) the auriculo-ventricular ratio. It is possible, by means of various formulae and tables to calculate what these measurements should be in a normal person for any given combination of age, height and weight, so that if the predicted normal measurements are known for any film then it is possible to find out whether the actual measurements exceed this—or, in other words, we have a numerical index of cardiac enlargement. In the present series, 43 cases of Rheumatic Heart Disease were X-rayed, with a series of controls, at Hallam Hospital.](https://iiif.wellcomecollection.org/image/b3025923x_0034.jp2/full/800%2C/0/default.jpg)
