Silent mitral regurgitation.

The occurrence of significant mitral regurgitation whithout the characteristic auscultatory signs, particularly the holosystolic murmur and the third heart sound, is unusual. It becomes of considerable importance when it occurs in combined lesions of the mitral valve, and more so in those areas where the treatment of mitral stenosis is by closed mitral valvotomy. Two cases of silent mitral incompetence are presented.

Congenital heart disease in Ceylon.

An analysis of 555 consecutive cases of congenital heart disease in Ceylon has shown that for the whole series interatrial septal defect is the commonest cardiac lesion; next is interventricular septal defect, followed by persistent ductus arteriosus. Interventricular and interatrial septal defects are equally common among all the patients below 16 years of age, but interventricular septal defects are commonest among those below 11 years. Persistent truncus arteriosus is unusually common, while coarctation of the aorta and congenital aortic stenosis are rare, as compared with series reported from other places.