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心臟瓣膜症에 관한 臨床的 觀察

CLINICAL OBSERVATIONS ON THE VALVULAR HEART DISEASE

대한의학협회지 1970년 13권 4호 p.327 ~ 336
서정돈,
소속 상세정보
서정돈 (  ) - 서울대학교 의과대학 내과학교실

Abstract


Valvular heart diseases are clinically important heart diseases chiefly found in the young adult. During the past 6 years, 1963 to 1968, the author has observed clinical features and laboratory findings of 209 cases of valvular heart diseases at the Seoul National University Hospital and has obtained the following results.
1. The incidence of valvular heart disease in proportion to the total number, of patients hospitalized during the period stood at 1.7%, of whose sex in cidence males were 48.3% and females 51.7%.
Incidence of valvular heart disease were: mitral stenoinsufficiency 44. 5%, mitral stenosis 20.6%, mitral insufficiency 16.3%, combined valvular disea8.6%, aortic insufficiency 4.8%, aortic steno-insufficiency 4.3%, pulmonary stenosis 0.5%, and aortic stenosis 0.5% in that order.
As for the age incidence,those in the age bracket of 26 to 35 years were most predominant and those both above and below this range were in gradual decrease.
2. The following were found as etiological factors: rheumatic fever 97.8%, arteriosclerosis 1.4%, and syphilis 0.7%.
In the past history, the following were observed: rheumatic fever, arthritis, frequent sore throat, arsyphilis, fever unknown origin and others.
3. Main symptoms were: dyspnea, palpitation, fatigability, cough, headache dizziness, cyanosis, hoarseness, liver enlargement, edema, pulmonary congestion, arrhythmia, thrill, bloody sputum and clubbed finger.
4. As complications of valvular heart disease, the following were observed; auricular fibrillation 39.4 %, cerebral embolism 11.4%, cardiac cirrhosis 3. 5% and subacute bacterial endocarditis 0.7%.
5. The disturbance of liver functions were found in many cases of decompensatory valvular heart disease.
6. In electrocardiogram, `the following were obsrved auricular fibrillation 39.4%, right bundle branch block 7.7%, left bundle branch block 1.4% ventricular extrasystole 13. 3%, and first degree A-V block 6.3%.
In electrocardiographic heart position, the follow ing were observed; vertical 56.7%, semivertica1 23.1%, intermediate 15.4%, semihorizontal 2.8%, and horizontal 2.1%.

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