760 THE AMEXI(‘AN HEART JOURNAL

Hadorn, W. : Observations of the Heart in Hypoglycemic Shock (in Relation to the Electrocardiographic Changes in Insulin Treatment of Schizophrenia With

Notes on the Effect of Cardiazol on the Electrocardiogram in the Same Con- dition) . Arch. f. Kreislaufforsch. 2: 70, 1937.

This is a prcscntation of monographic proportions whicah corers over SO pages and contains the author’s extensive studies correlating work on animals and patients.

Insulin shock in schizophrenic and in normal subjects causes, in many persons, taehycardia and a rise in blood pressure with increase11 pulse pressure and venous

pressure. Angina pect,oris may also occur in diabetics with coronary sclerosis, but

similar pain may he found in schizophr&cs without hrart tlisease. These changes are attributed in part to a liberation of allrenalin. It is concludetl that insulin is to

be used cautiously in coronary sclerosis.

In the electrocardiogram insulin causes increaser1 amplitude of P and &KS, pro-

longation of QRS am1 P-R, coronary nodal rhythm, extrasystoles of auriculxr and

ventricular origin, depression of S-T, prolongation of dcctrical systole, and flattening and inversion of T. These elec,trocardiographic changes indicate again the hazard

of insulin usage in coronary disease. Cardiazol (tetrazol) causes murh less change in the el~ctrocartliogram than rloes insulin. There is, however, a tendency toward auricular rxtrasystoles ant1 ~uri~ular fibrillation.

KhTZ.

Albers, D., and Thadclea, S.: Electrocardiographic Changes in Experimental and Clinical Adrenal Insufficiency. Ztschr. f. Breislaufforsch. 29: R?5, 1037.

Adrenal insuffic,iency causes tlecrcasr~l amplitude of Ileflec,tions, depression of S-T,

and inversion of T. The deviations tend to return toward normal when the cortical

hormone is supplied. The damage to the heart muscle was ,dcmonstratell his- tologically, but not in all cases.

K.I~Yz.

Bellet, Samuel, and McMillan, Thomas K: Electrocardiograpihc Patterns in Acute Pericarditis: Evolution, Causes and Diagnostic Significance of Patterns in Limb and Chest Leads; A Study of Fifty-Seven Cases. Arch. Int. Med. 61:

381, 1938.

The electrocardiographic findings in fifty-seven cases of acute pericarditis of dif- ferent etiologic types are presented and discussed,

On the basis of these observations it is concluded that in a large majority of cases (80 per cent in this series) electrocardiographic changes are associated with peri- carditis. In twenty-one cases (more than n7 per cent) the alteration in the RST seg- ment conformed to a pattern which we regard as fairly characteristic, namely, eleva- tion of the RST segment in the three limb leads, depression of the interval in Leads IV and V and elevation of the interval in Lead vr, with preservation of the initial downward deflection. In the remainder the inversion of the T-wave and minor changes in the RST segment, which are considered important, were noted. In the main, the deviation in the RST segment was observed in association with the more virulent forms of pericarditis, e. g., pneumococcic, uremic. and rheumatic; the altera- tion in the T-wave was the outstanding cahange present in cases of tuberculous peri- carditis.

The deviation in the RST segment ami the change in the T-wave are transient; for this reason it is important to obtain elect,rocardiographic. records at frequent intervals.