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鬱血性心不全症의 臨床的 觀察

Clinical study of congestive heart failure

전남의대잡지 1968년 5권 2호 p.253 ~ 263
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Abstract


A two hundred and sixty two cases of congestive heart failure were clinically studied, which were diagnosed and classified statistically at the department of internal medicine, Chonnam University Hospital from 1964 to 1967.
The following results were obtained.
1. Both sexes were affected equally, and the highest incidence of the age was in 5th and 4th decade.
2. Frequency of etiology in underlying disease was as follows; Hypertensive heart disease was seen in 47.3%, rheumatic heart disease in 32.8%, arteriosclerotic heart disease in 6.9%, chronic pulmonary heart disease in 3.4%, postpartum heart: disease in 2.7%, pericardial disease in 2.3%, congenital heart disease in 2%, syphilitic heart disease, myocardial disease and anemic heart disease in 0.4%
3.The duration of symptoms was relatively shorter in hypertensive and arteriosclerotic heart disease than rheumatic heart disease.
4. The level of blood pressure was noted highest in hypertensive and arteriosclerotic heart disease on both systolic and diastolic pressure.
Of hypertensive and arteriosclerotic heart cases, 44% manifested 180-200 mmHg, 12%..160-180 mmHg, 9% 220-240 mmHg and 2% below 100 mmHg in systolic blood pressure, 40 % of the cases showed diastolic pressure of 100-120 mmHg., 38% above 100mmHg 17% 90-100rnmHg and only 5% under, 90 mmHg. 35% of rheumatic heart disease revealed systolic blood pressure over 140 mmHg and diastolic blood pressure over 90 mmHg was seen in 46% of cases.
5, The frequency of valvular involvement in rheumatic heart disease was as follows; mitral stenosis with mitral regurgitation in 38.2%, mitral stenosis in 26.1%, mitral regurgitation in 6.0%, mitral regurgitation associated with mitral stenosis, aortic regurgitation and stenosis in 3.5%, aortiv stenosis, aortic regurgitation, aortic stenosis with aortic rgurgitation 2.3% respectively and ticusoid valvular disease in 1.3%, and exact site of valvular lesion could not be determined in 17% of cases.
6. Dyspnea was seen in 86%, edema in 63%, orthopnea in 50%, coughing in 34%, gastrointestinal disturbance in 31%, chest pain in 15%, cerebral symptoms in 9%, hemoptysis in 8% and cyanosis in 3%.
7. Physical examination revealed edema in 87%, cardiomegaly in 83%, hepatomegaly in 65%, heart murmur in 62% ascites 55%, and pleural effusion in 8%.
8. Laboratory examination revealed that mean hemoglobin was 12.5gm%, cholesterol 260 mg%, N.P.N. 57.8 mg%, serum protein 6.24gm% and serum potassium 4.03 mEq/L, and proteinuria was seen in 43% of the cases.
Of the cases who had anemia, 41% manifested macrocytic; 29%, normocytic and 300 microcytic anemia.
9. Left ventricular hypertrophy was seen in. 83.3%, atrial fibrillation in 26.9%, right ventricular hypertrophy in 18.5%, right atrial hypertrophy in 1.8% on electrocardiogram. Left bundle bunch block was also observed but it was rare.

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