Characteristic configurations are often to be seen in the various forms of valvular and congenital heart disease, in syphilitic artistes and in aneurysm of the heart. Congestion and oedema of the lungs and small pleural effusions can be shown radio logically before they can be detected clinically. The individual chambers of the heart and the great vessels may be visualized by the injection of a radio opaque material into a vein or by catheter directly into the heart before taking a series of radiographs in rapid succession. Such studies are very useful in the differentiation of various congenital cardiac lesions and of vascular from other abnormal meditational shadows. The phonocardiorgraph records heart sounds and murmurs and may help to elucidate difficult problems of auscultation.
A characteristically symmetrical inversion of the T wave is seen in myocardial injury and usually follows displacement of the S-T segment within a period of a few hours or several days. Thereafter the T wave gradually returns to normal, but may remain permanently inverted. By means of these ST-T wave changes, the age of a myocardial infarct can often be assessed and serial electrocardiograms are particularly valuable in this respect. The preceding account of electrocardiography is greatly simplified and details have not been given of the many normal variants which may be encountered, or of the minutiae of diagnostic criteria. For a fuller account, reference should be made to a standard book on unipolar electrocardiography. It must be emphasized however that, while some understanding of electrocardiography is of value to all students and practitioners of medicine, interpretation of electrocardiograms (and particularly prognostic judgments) should only be made by physicians experienced in this field.
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