Catalogue of the Pathological Museum of the Glasgow Royal Infirmary / edited by David Foulis.

Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: Catalogue of the Pathological Museum of the Glasgow Royal Infirmary / edited by David Foulis. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    SEUIES III.] former division of the existing ones. The malformation does not appear to have led to any inconvenience during life, the patient having presented the symptoms and signs of bronchitis and emphysema. There was considerable hypertrophy of the right ventricle of the heart, but not at all of the left. [Path. Eep., Jan. 14, 1874.] 117. Aortic valvular disease : congenital malformation of the valve: patent foramen ovale. Preparation Avas removed from a boy nine years of age. The aortic valve and its neighbourhood presents numerous irregular prominences, almost sufficient to obstruct the orifice. These formations are chiefly attached to the semilunar curtains, but they are also present in considerable mass on the wall of the ventricle beneath the valve, and on the proximate curtain of the mitral. In fact, the vegetations in these latter positions form a kind of second aperture half an inch beneath the level of the aortic valve, and into this aperture project the more bulky vegetations of the curtains, in such a manner as almost to obstruct it. The aortic valve presents only two semilunar curtains of nearly equal size. These may be distinguished as a left posterior and right anterior; the former being nearly normal in shape, but large ; the latter showing an indication of division into two, as follows :—from a point about half an inch above the middle of the valve a narrow band passes down the aortic wall, to which it is firmly adherent: at the base of the curtain this band divides into three smaller ones, which spread out on the semilunar fold. The appearance reminds one to a certain extent of a columna carnea, giving off its chordfe tendinea3. In the semilunar curtains there is no appearance suggestive of chronic endocarditis, the curtains being comparatively thin, except where the vegetations are attached. Just above the valve there is a pouch in the aorta, projecting to the right. Viewed externally this pouch is about the size of a half Avalnut. Internally it presents numerous irregular vegetations. The foramen ovale is found to be pervious, admitting a tube of a quarter inch diameter; the aperture is widest on the right side and passes obliquely forwards to the left, so that on the left side it is almost valved. The heart was very much enlarged, weighing llJj oz. (in a boy of nine years). It extended from the right border of the sternum as far as two inches to the left of the nipple. The spleen was enlarged (8^ oz.), and it as well as the kidneys presented old and recent evidences of embolic phenomena. Patient presented during life symptoms of cardiac disease with