Summary: Between January and September 1985, 476 patients underwent two-dimensional and M-mode echocardiography . Left ventricular bands were noted in 104 of these individuals. Of these patients, 89 (85.6%) WCIY refemd for evaluation of a systolic murmur. In view of this high incidence of association between left ventricular bands and systolic murmurs, we decided to perform a prospective analysis on patients with the classical vibratory systolic murmur (Still's murmur) which is commonly found in children and young adults. The incidence of lcti ventricular bands would be compared with a group of individuals in whom no cardiac murmurs could be detected. It was hoped in this way to possibly determine whether there was a definite relationship between the vibratory systolic murmur and left ventricular bands. Echocardiographs were performed using an Advanced Tcchnical Laboratories machine and gain settings were adjusted such that all artefacts and normal structures could easily be distinguished from the ventricular bands. The vcntricular bands were divided into two types. Of significance, we felt, were those which crossed the left ventricular outflow tract and which could therefore have been responsible for the production of turbulence and thus a niuniiur reminiscent of the Still's murmur. This type of Icft ventricular band was noted in 76% of our patients with Still's niuniiurs as opposed to only 14% of the individuals without any murmur (p

South Africa 10 asymptomatic young male patients with moderate splenomegaly detected at a routine examination are presented. The history and clinical examination failed to reveal the aetiology of the splenomegaly. Further investigations, including screening for blood dyscrasias, clotting abnormalities and reticuloendothelial abnormalities were likewise unrevealing. Liver biopsies, rectal biopsies for bilharzia and bone marrow aspirates for Gaucher's Disease were found to be normal. Serology for malaria and Ebstein Barr Virus infection was also negative. Positive immunofluorescent tests for IgG antibodies specific for cytomegalovirus were found in 5 patients. We consider that these patients have splenomegaly which is not of a specific nature, but may be associated with a severe antigeneic response to the previous cytomegalovirus infection. In view of the otherwise negative findings these patients should be considered to have 'True Idiopathic Splenomegaly', a term which would indicate the benign nature of the splenic enlargement. This diagnosis should be considered in the differential diagnosis of asymptomatic patients who have splenomegaly of undetermined origin. % I lympho-

Three cases of acute inferior wall myocardial infarction associated with complete atrioventricular block and junctional escape rhythm showing left posterior hemiblock are presented. The triad appears to consitiute a distinct syndrome. It is postuated that the subsidiary pacemaker is situated either in the bundle of His or the proximal part of the anterior division of the left bundle-branch.