On inadequacy of the valves of the aorta / by William Henderson.

  • William Henderson
Date:
[1837?]
Catalogue details

Licence: Public Domain Mark

Credit: On inadequacy of the valves of the aorta / by William Henderson. 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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    and in this instance, altliough a very extensive aneurism, occu- pying a large portion of the right side of the chest, and still pervious to blood, the pulse of the heart and arteries bore their usual relation to each other. Nor is it surprising that it should be so, when we remember, as Haller remarks, that the blood resumes its velocity after having passed an aneurism,—indeed, were it otherwise, the sac would necessarily undergo a perma- nent increase of size from every new influx of blood—and that the expansion of an aneurism at each pulsation probably is, as in the healthy arteries, more apparent than real. In concluding this brief notice of incompetency of the aortic valves, it may be of use to sum up what appears to be warrant- ed regarding the more prominent signs by the accumulated ob- servations of different authorities. 1st. Visible pulsation, or remarkable leaping of the arteries of the head and upper extremities, is a very common attendant on the disease,—yet not worthy of being considered a pathog- nomic sign, because it is not always present in a degree of pe- culiar significance, may result merely from a greatly enlarged left ventricle (to which, indeed, M. Guyot attributes it in pa- tency of the valves,) and may be caused by continued nervous excitement (Corrigan) ; nor is its true cause revealed by 'idly. Bruit de soufflet and fremissement, accompanying the diastole of the arteries, as maintained by Dr Corrigan, for the former of these may result from mere irritability (Hope,) and the latter is often absent altogether in cases of patency. These phenomena may also result from disproportion between an en- larged ventricle and the orifice of the aorta, and from vegetations on the valves. Sdly. A bellows-murmur, in place of the usual second sound, most audible along the track of the aorta and its primary branches, is an indication of patency of the aortic valves, ex- cept in those rare cases of aneurism in the course of the sub- sternal aorta which have the power of originating two mur- murs, (Edin. Med. and Surg. Journ. No. 127.) The musi- cal or cooing note, in place of the second sound, has hitherto been found to originate only in cases of patency of these valves. The morbid murmur during the diastole of the heart, whether a bellows-sound or a sonorous note, may, contrary to the opinion of Dr Hope, be very loud in cases of incompetency of the valves. In some cases, however, there are no such sounds. '^thly. The occurrence of a preternatural interval between the period of the heart's contraction, and of the remote arterial pulse, promises to prove a valuable sign of inadequacy of the aortic valves. Should it prove on further inquiry to be con- stant, it will remove the difficulties in the differential diagnosis of patency.
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