[Report of the Medical Officer of Health for Kensington Borough]
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Table: C.— Basal murmur unchanging—previous history of juvenile rheumatism.
C.— Basal murmur unchanging—previous history of juvenile rheumatism.
Case.
Site.
Posture.
Persistence after first heard.
Electro-cardiogram.
Remarks.
P.H.
Maximum T.A., P.A.
L. and S.E. > I
3 years.
Physiolog.
Arthritis when first seen, and well since, but developed localised apical murmur.
JP.
T.A. and P.A.
L. only. E. > I.
1½ ,,
Slight left axis de-viation and de-lay in conduct-tion.
Mitral incompetence developed after sub-acute attack.
E.B.
Maximum T.A., P.A. and A.A.
L. > S. E. > I.
2 „
Physiolog.
No further evidence of rheumatism, but mitral incompetence developed.
D.—Basal murmur not heard when first seen—previous history of juvenile rheumatism.
S.R.
Maximum T.A., P.A. and A.A.
S. and L. E. > I.
20 months
First diastole short, T, deeply in-verted second physiolog.
History of acute attack 6 months before. Well 1 year. Then sub-acute attack followed 7 months later by mitral incompetence.
J.W.
T.A. only.
L. only. E. and I.
No. Heard for 6 months.
Left axis deviation and P, sharply inverted.
History of acute attack. Nil since.
Table: GROUP III.—Basal murmur following other signs of carditis noted at centre.N.B.—All these cases therefore have history of juvenile rheumatism before onset of murmur, which was not present when first seen.
GROUP III.—Basal murmur following other signs of carditis noted at centre.N.B.—All these cases therefore have history of juvenile rheumatism before onset of murmur, which was not present when first seen.
Case.
Site.
Posture.
Persistence after first heard.
Electro-cardiogram.
Remarks.
D.H.
T.A.
S. and L.
8 months.
First very short diastole. Later physiolog.
Tachycardia and slight enlargement. Murmur developed 10 months later. Patient very well.
W.N.
Maximum T.A., P.A. and A.A.
L. only.
2½ years.
P—R= 12 min.
Active carditis. Basal murmur de-veloped 1 year later. Later mitral incompetence without further rheu-matism.
W.H.
P.A. and A.A.
,,
1½ ,,
T, very small.
Murmur developed 1½ years after acute attack.
T.D.
Maximum T.A., P.A. and A.A.
E>I.
1½ ,,
-
Active carditis 2 years before basal murmur heard. Second attack after murmur developed, with transitory apical murmur.
E.W.
T.A. and P.A.
L>S.
2 ,,
Left axis devia-tion.
Acute carditis 1 year before basal murmur developed.
D.W.
,, ,,
S. and L.
2 ,,
Left axis devia-tion, low vol-tage.
Acute carditis 1 year before basal murmur heard.
A.B.
Maximum T.A., P.A. and A.A.
Only after exercise E.> I.
6 months.
Full P—R.
Acute carditis 4 years before basal murmur heard.
D.G.
T.A. and P.A.
L. only. E>I
1 year.
Full P—R. Shortdiastole.
No acute attack. Prolonged conduction noted before basal murmur.
Table: GROUP IV.—Basal murmur coincident with other signs of carditis.
GROUP IV.—Basal murmur coincident with other signs of carditis.
Case.
Site.
Posture.
Persistence after first heard.
Electro cardiogram
Remarks.
G.B.
P.A., T.A. and A.A.
L. only.
1 year.
Delayed conduction. Later, physiolog.
Acute carditis when first seen. No mitral lesion persists.
P.B.
Maximum T.A., A.A.
L. only. E. > I.
2½ years.
-
Acute attack with apical murmur 6 months before. Later apical localised murmur only.
R.B.
P.A.
L. > S.
1 year.
-
Acute carditis and chorea. Later no apical murmur.
S.C.
Maximum T.A., P.A.
L. > S. E. > L.
3 years.
Physiolog.
During attack when first seen localised apical murmur, heart not enlarged. Later conducted. No further attacks.
C.D.
Maximum T.A., P.A. and A.A.
,,
1½ ,,
Very abnormal.
Doctor gave history of acute attack with pericardial friction.
F.D.
,, ,,
L. and S. E. > I.
2 „
—
History of chorea, apical murmur, later conducted.
R.L.
T.A.
L. and S.
20 months
Delay in conduc-tion.
History of pain and apical murmur. Disappeared later.
L.L.
Maximum T.A., P.A.
L. > S. E. > I.
5 years.
Physiolog.
Since pneumonia at 2 years, history of heart trouble. Feverish attacks and pains.
N.B.—(1) By rheumatic pains we mean pains which are present at rest as well as when walking. They are
often in the arms or back of neck as well as in the legs, and no other cause can be found for the
pains.
(2) Where acute or active carditis is mentioned, there has been some definite sign of cardiac involvement
; if enlargement, it is often by clinical tests only, for it has not been possible to screen in the
upright position until lately.
