Disturbances of the Heart by Oliver T. (Oliver Thomas) Osborne
page 75 of 323 (23%)
page 75 of 323 (23%)
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patient is being treated, to establish the diagnosis.
Rowan finds the reading of the pulse pressure to be of great importance, as this will indicate, sometimes before any other symptom is present, that the patient is either improving or doing badly, and it also aids in indicating the proper medicinal treatment. In arteriosclerosis the systolic pressure may be high while the diastolic is low; hence there is a large pressure pulse. If the heart becomes weak the systolic pressure will drop, and any improvement caused, especially in aortic regurgitation, is by an increase of the systolic pressure. Rowan finds, as has long been recognized, that a conclusion as to whether or not cerebral hemorrhage will occur cannot be made from the condition of the radial arteries, as patients with soft radials may suffer from cerebral hemorrhage, while those "with hard, sclerosed, pipestem-like arteries may live to a great age and die of anything rather than apoplexy." Swan, [Footnote: Swan: Interstate Med. Jour., March, 1915, p. 186.] has studied the blood pressure in fifty cases of disturbed thyroid, and finds that functional myocardial tests show that the myocardium is nearly always disturbed in these patients. Before taking up the subject of treatment of high blood pressure, it may be suggested that a high diastolic pressure with a falling systolic pressure may require vasodilators on the one hand or cardiac tonics on the other, and sometimes the decision can be made |
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