The diagnostic signs of incompetence of the pulmonary valve / by G. A. Gibson.

  • Gibson George Alexander, 1854-1913.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: The diagnostic signs of incompetence of the pulmonary valve / by G. A. Gibson. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    cusps to close completely, in consequence of the high pressure within the pulmonary circuit. In spite of every method of treatment, the patient became steadily worse. The dependent parts developed more oedema; ascites and hydrothorax came on; the urine fell off in quantity, and contained more albumin; and the dyspnoea and cyanosis increased. Death occurred quietly on 7th July. The post-mortem examination was performed the following day by Dr. Leith, whose notes, for which my thanks are due to Mr. J. Stuart Gallie, are appended. Extei'nal appearances.—Eigidity absent. Lividity well marked. There is considerable dropsy. Thorax.—There are extensive old adhesions in both pleural sacs. Heart.—The pericardium is adherent all over; the ad- hesions are slender, and easily broken through. They are extensive botli in front and behind, chiefly consisting of fine threads attaching the two surfaces together. There are two large irregular nodulated masses of osseous consistence, one to the right of the pulmonary artery, which is the larger, about the size of a hazel nut; the other to the left of the pulmonary artery. Both are very irregular in shape, very jagged and nodular on their external surfaces, and lie in both layers of the pericardium, the two layers being here inseparable. Pulmonary valves are incompetent. Aortic „ „ Cone diameter of pulmonary = ‘86. „ „ aortic = ‘6. All the pulmonary cusps are thickened. This is especially marked at then* attachments, where it is almost cartilaginous in consistence. The lunule also shows considerable thickness, although it is not so pronounced. Their attachment to the artery is also thickened. The condition is one of well-marked chronic endocarditis. There are some recent vegetations at junction of anterior and right posterior cusps. At the right margin of the right posterior aortic cusp there is an irregular perforation larger than a crow quill;
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