CIRCULATION TIME IN FAILURE OF THE LEFT SIDE OF THE HEART

Increased attention has been devoted of late to the old clinical concept of left ventricular failure. Excellent surveys have been reported by White 1 and by Weiss and Robb. 2 The clinical manifestations are those resulting from pulmonary engorgement, and include various combinations of the following: exertional dyspnea, cardiac asthma, orthopnea, cyanosis, cough, blood-streaked sputum, physical signs and roentgen evidence of pulmonary engorgement, diminution in vital capacity, pulmonary edema, dilatation of the left ventricle and auricle, accentuation of the pulmonic second sound, the systolic murmur of relative mitral insufficiency, gallop rhythm, fall in arterial pressure and, rarely, alternation of the pulse. On the other hand, engorgement of the systemic veins, swelling of the liver, dependent edema and other manifestations of insufficiency of the right side of the heart are absent. The characteristic clinical picture of isolated failure of the left side of the heart is encountered only when the functional