Left ventricular failure due to essential hypertension

Abstract 1.1. Isolated failure of the left ventricle due to essential hypertension, the type that has a lower mortality than the combined failure of the right and left ventricles (congestive heart), is reported in 190 patients, the great majority of whom were males in the age. 2.2. Dyspnea and cardiac pain, alone or combined, were the leading symptoms at the onset in 89 per cent of the patients; in the other 11 per cent dyspnea was present along with palpitation or weakness. 3.3. Congestive heart failure, the common cause of death among patients with hypertensive heart disease, accounted for only 36.4 per cent of the deceased, but the duration of life after the onset of the congestive failure was less than six months in each of the 16 patients. 4.4. Coronary thrombosis, which was the cause of death in 10 per cent of patients with hypertension who died with all types of cardiac failure, and in only 6.6 per cent of those with gross arteriosclerosis, accounted for 36.4 per cent of the deceased in this series. 5.5. Auricular fibrillation occurred in 38 (20 per cent) of the 190 patients, and was the most common arrhythmia; the mortality was lower than in those with regular rhythm due to the absence of coronary thrombosis. 6.6. The studies of Roberts, Wearn, and the Shipleys suggest that the occurrence of failure of the left ventricle in essential hypertension, due to the disturbed relation between muscle fiber size and the volume of blood flow through the capillary bed, may be the precipitating factor of the coronary thrombosis, especially where coronary sclerosis already exists. 7.7. Coronary thrombosis, according to this analysis, should be kept in mind constantly during the treatment of isolated failure of the left ventricle in essential hypertension, and especially if the rhythm is and remains regular. Nevertheless, these patients with hypertension, on the whole, have a better prognosis than those who developed the combined type of hypertensive (congestive) heart failure where the occurrence of coronary thrombosis is a rarity.