On the systolic blood-pressure in the arm and leg in aortic incompetence / by H.D. Rolleston.

  • Rolleston, Humphry Davy, 1862-1944.
Date:
1912
Catalogue details

Licence: In copyright

Credit: On the systolic blood-pressure in the arm and leg in aortic incompetence / by H.D. Rolleston. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    compensated aortic regurgitation, the maximum systolic blood-pressure in the arm was usually about 140 mm. Hg, and that in the leg 350 mm. Hg, the difference of 210 mm. being remarkable. In another man aged 23 years with compensated aortic regurgitation there was a difference of 195 mm. (arm 125, leg 320). In cases of aortic regurgitation, in which the compensation is strained or lias broken doivn, the difference between the arm and leg pressures is less than in cases of compensated aortic regurgitation, but is usually distinct. I have seen cases in which, as in one of Hill’s cases of combined aortic and mitral disease, there was less than 20 mm. Hg difference between the leg and arm pressures. In Hill and Rowlands’ paper the records of the blood- pressures show very clearly that in uncomplicated aortic regurgitation the difference between the arm and leg pressures is considerably greater than in cases of combined aortic and mitral disease. Hill and Rowlands do not comment on this point, but their results render it unnecessary to give any further records. In aortic regurgitation of recent origin, before compensation is estab- lished, the difference between the systolic blood-pressures in the arm and leg is comparatively slight or may even be absent. A boy aged 14 was admitted to St. George’s Hospital in the third week of rheumatic fever with signs of pericarditis and aortic regurgitation. The systolic blood-pressures on different days were Leg. Arm. 120 100 90 100 100 90 130 120 95 95 A man with primary infective endocarditis of the aortic valves (confirmed by necropsy), which ran its course within 6 weeks, had a waterhammer pulse but the difference between the systolic blood-pressure in the leg (140) and in the arm (120) was only 20 mm. Hg. It is natural to compare the effect of fever with that of the application of hot water to the legs on the systolic blood-pressure in aortic regurgitation. In a boy aged 17 years with aortic and mitral regurgitation and strained compensation the average difference between the systolic blood-pressures in the arm (130 mm. Hg) and the leg (185) was 55 mm. Hg ; but during some attacks of fever, the highest temperature being 101-4 F., the difference