Abstract
On the service of Dr. Harold Neuhof at The Mount Sinai Hospital, New York, we have had the unique opportunity of making cardiovascular studies of patients with one functioning lung. Multiple thoracoplasties were performed by Dr. Neuhof for unilateral chronic empyema, pulmonary tuberculosis or lung abscess. The lung on the non-affected side was normal. Table I.
Dyspnoea on exertion, not at rest, was universally present. There were no orthopnea and cyanosis. The hearts were normal, although perhaps displaced and slightly rotated. This was judged by physical examination, teleoroentgenogram, fluoroscopy and electrocardiogram. In 2 cases there was a tendency to right ventricular preponderance on the electrocardiogram, probably the result of the long standing previous pulmonary disease with slight rotation of the heart. In one case there was a definite left ventricular preponderance.
The pulse rate was always rapid. The blood pressure was normal. The respirations were usually 20 per minute, occasionally 28 per minute, but the slightest exertion increased the respirations. The vital capacity was markedly diminished, ranging between 1200–2700, the normal being 3500–4500. The venous pressure by the direct method 1 was definitely elevated on the involved side in one case. The velocity of the blood, measured from the arm to the tongue 2 or the arm to the lung, 3 was definitely increased, that is, the circulation time was decreased. In every case the mediastinum was fixed except that a shifting mediastinum was present for a short time in one patient (J. G.). On inspiration the entire mediastinum moved to the left and on expiration to the right. This produced decided embarrassment to the patient, i. e., marked dyspnoea and orthopnea, even while he was in bed.
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