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Examination. Weight 7,080 Gm., temperature 40 C., pulse 160 per minute, respiration 60 per minute, blood pressure 90/50 mm. Hg in the armis and 110/60 mmii. Hg in the legs. He was pale, lethargic, hypoactive, and in moderate respiratory distress with retraction of the lower intercostal spaces. The left precordiunm bulged slightly. The heart was enlarged to the anterior axillary line in the sixth intercostal space. A systolic thrill was felt in the suprasternal notch and in the second intercostal space along the right sternal border. A harsh, ejection-type, systolic murmur was heard at the base of the heart, equally well both to the right and to the left of the sternum, and at the left lower sternal border. It was heard faintly over the neck vessels and the lung fields posteriorly. Diastole was clear except for a gallop

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