SOME UNUSUAL DISTURBANCES OF THE MECHANISM OF THE HEART BEAT

Abstract
AN ECTOPIC TACHYCARDIA OF FIFTEEN MONTHS' DURATION Attacks of simple paroxysmal tachycardia usually last but a few hours or at most a few days. Lewis1 states that attacks which last a fortnight are rare and that longer attacks are unknown. D. C. Wilson2 has recently reported an instance in which an attack of ten days' duration was followed by the development of gangrene of the forearm. This is the longest attack described in the recent literature. We were surprised, therefore, to encounter a patient with a tachycardia of this type that had persisted for approximately fifteen months. Case 1.—History. —Mr. E. K., and American student, aged 22, first seen by us in July, 1920. He complained of palpitation associated with rapid heart action. There was a history of whooping cough and measles in childhood, but none of rheumatic fever, chorea, scarlet fever or diphtheria. The patient had a severe atttack