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SYNDROME OF SUBNORMAL CIRCULATION IN AMBULATORY PATIENTS

ISAAC STARR, M.D.; LEON JONAS, M.D.
Arch Intern Med (Chic). 1940;66(5):1095-1111. doi:10.1001/archinte.1940.00190170086006.
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In this communication we describe the signs and symptoms commonly found in ambulatory hospital patients who have subnormal basal or resting circulations, ascertained by estimating their cardiac output. The clinical syndrome exhibited by such patients is definite enough to permit the diagnosis of this abnormality in many instances when methods of estimating cardiac output are not available.

Determinations of cardiac output were begun in this hospital in 1927 by means of the ethyl iodide method.1 At first extremely slow and laborious, the speed of operation was later increased by adaptation of the katharometer to our analytic needs by Donal and Gamble.2 In all, 335 subjects were tested by this method over a period of eight years.3 The advent of the ballistocardiogram4 permitted us to estimate cardiac output with a speed and ease of operation equal to those of other routine clinical methods. In the last three years the total experience

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