Abstract
On the basis of a pulse-ratio method Tuttle and Wells 1 showed quite conclusively that in the case of the normal heart the increase in rate caused by exercise is directly proportional to the intensity of the exercise and that the form of the curve representing the relationship between heart rate and exercise intensity is rectilinear. It occurred to us that if abnormal hearts did not conform to this principle a simple method for detecting them is provided.
By using the pulse-ratio technique data were collected from 32 University freshmen reported as having abnormal hearts. The physicians' report of these cases at the time of examination was as follows: 6 cases of functional murmur, 16 cases of organic lesion in which there was definite evidence of decomposition, 6 cases of organic lesion with no signs of heart failure, 2 cases of neurogenic lesion∗ and 2 cases which could not be agreed upon as to class. Each case was examined upon 2 different occasions by the pulse-ratio test.
The data show that in cases of functional murmurs, compensated organic lesions and neurogenic lesions, the response to exercise is exactly the same as with normal hearts. However, where noncompensated organic lesions are present the response to exercise is not always directly proportional to the intensity of the exercise and the curve representing the response is never rectilinear.
In 2 cases in the group there was a difference of opinion as to the nature of the heart lesion. Repeated examination by the pulse-ratio technique placed both of these cases in the non-compensated organic lesion group. In these cases the physician agreed that there was sufficient evidence of heart lesion to justify restricted activity.
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