Memorandum to Captain Harper:
Fluoroscopy and X-ray of the heart show a distinct increase in the size of the cardiac shadow as measured in the anterior posterior position. The contractions along the left border in this view are limited, although more vigorous pulsations are noted posteriorly in the left anterior oblique positions. The enlargement of the heart is mainly of the left ventricle. The great vessel shadow has also increased in size. This enlargement is apparently due to a diffusely dilated and torturous sorts and includes the ascending, arch, and thoracic portions.
In view of the continued low grade pulmonary infection, cough and dyspnea on effort it is suggested that these symptoms might well be aggravated by, or due to, the presence of early left ventricular failure with engorgement of the pulmonary vessels.
Rest with nursing case for a period of 1-2 weeks.
Digitalization. ¾ gram digitalis every day for 5 days; subsequently /1 gram every day.
A light easily digestible diet, Portions are to be small and salt intake is to be restricted. Potassium Chloride in a salt shaker may be used as desired for seasoning.
Sedation should be employed, to insure rest and a refreshing night’s sleep.