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Since the basic studies of Rohrer (1916) and Kahlstorf (1932), much work on ellipsoid approximation techniques for cardiac volume estimation has been done in Sweden. Publications such as those of Jonsell (1939), Kjellberg, Lonroth, and Rudhe (1951), and Maurea, Nylin, and Sollberger (1955) bear testimony to the careful and critical way in which the many problems concerned have been tackled. As a result of such work, there has been evolved a method of estimating heart volume from three simple measurements of the cardiovascular outline as seen in standard posteroanterior and lateral radiographs. The validity of the estimates so obtained can best be judged from the post-mortem studies of Lind (1950) and Friedman (1951), who found remarkably close correspondence between actual heart volume (measured by displacement) and radiologically-estimated volume.Nylin (1955, 1957) used this method when studying changes in heart volume and blood volume, and outr own interest in these volume relations during heart failure first led us to use it. This initial experience with the technique encouraged us to extend its use into routine clinical practice and as a result there are available data from 185 patients, almost all with heart disease. Analysis of these data, here presented, provides information about certain factors affecting heart size both in individual cases and in various groups of patients. SUBJECTS AND METHODSHeart volume measurements were made on 185 patients, all admitted to one ward of the Queen Elizabeth Hospital between 1958 and 1961. Two or more estimations were carried out on 31. Of these patients, 101 were male and 84 female. Apart from one child aged 6 years, they were between 17 and 83 years old. The great majority of them were suffering from some form of heart disease as indicated in Table I. (a) Radiological Technique. The method is basically that of Liljestrand et al. (1939). Standard chest radiograms were taken at tube-film distances of 2 m. (postero-anterior film) and 1-5 m. (left lateral film) with the patient erect: the prone position, for which Larsson and Kjellberg (1948) claim advantages, could not of course be considered for use in this series which included 76 cases of heart failure. No attempt was made to synchronize exposure with a particular phase of the cardiac cycle as this refinement adds so little to the accuracy of the estimate (Kjellberg et al., 1951;Ruosteenoja et al., 1958). The films were taken in full inspiration so that clear cardiac outlines were better seen and so that the radiograms were also suitable for ordinary routine reporting. Delineation of the posterior cardiac border was facilitated by giving the patient a little barium to swallow just before the lateral film was taken.From the postero-anterior radiogram the following measurements (in cm.) were obtained: "1"-the "long axis" of the cardiac ellipsoid-measured from the point of junction of the aorta (or superior vena cava) with the right heart border to the left lower pole of the heart. " b "-the " short axis "-measured fro...

Kinsey and White (1940) found clinical evidence of pulmonary infarction in 14 % of patients surviving episodes of cardiac failure and in 29% of those dying in heart failure but not submitted to necropsy. Where necropsy was carried out the incidence of pulmonary infarction was found to be nearly 50%. Wishart and Chapman (1948) found clinical or necropsy evidence of pulmonary embolism in only 6.5 % of patients with congestive heart failure given bishydroxycoumarin (dicoumarol) prophylactically. Subsequent trials have shown an incidence of thromboembolic complications ranging from 2% to 7% in congestive-failure patients given anticoagulants, as compared with 8 % to 33 % of controls

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