A case of patent ductus arteriosus, attended with a peculiar diastolic murmur / by C. Hilton Fagge, M.D.

Charles Hilton Fagge

Date:: [between 1800 and 1899]

Credit: A case of patent ductus arteriosus, attended with a peculiar diastolic murmur / by C. Hilton Fagge, M.D. 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.

4/12 page 4

$ingly \\\, and unable to lie down. Her face was flushed, but her skin cold. She said that she had been tapped at home, and that the parietes had afterwards given way at the umbilicus, allowing the escape of a large quantity of fluid. On auscultation a loud systolic murmur was heard at the heart's apex. 1 listened very carefully for the peculiar bruit at the apex, but, if audible at all, it was exceedingly faint, and certainly no unusual sound would have been noticed if attention had not been specially directed to it. The heart's pulsations were still only forty in the minute. Very few notes of her case were taken during the fortnight that intervened between her admission and her death. On March 2nd it is recorded that four punctures were made in the thighs. On the 7th the pulse was 48 per minute. On the 8th she was almost pulseless, her face and, lips were purple. She died on March 13th. I made a post-mortem examination on the following day (March 14th). The body was moderately emaciated ; there was considerable oedema of the legs, with inflammation of the skin. The head was not examined. The right pleural sac contained much fluid of a straw-yellow colour. The lower lobe of the right lung was compressed and airless. The bronchial tubes in both lungs were reddened, con- taining much mucus. The heart weighed twenty-two and a half ounces. Its apex was rather rounded. The left ventricle was dilated and hyper- trophied (a condition ascribed to the renal disease which was afterwards found), and the right ventricle likewise in appa- rently about equal proportion. The right auricle was greatly more dilated than the left, its appendix was opened out, and its enlargement might fairly be said to be extreme. The endocardium of the right auricle was opaque. The foramen ovale was closed. The tricuspid orifice was much enlarged, admitting five or six fingers. The muscular substance of the right ventricle was hard and tough. The mitral valve allowed four fingers to pass its orifice. In the endocardium of the left ventricle, about the musculi papil- lares and elsewhere, there were numerous yellow opaque patches, but the muscular substance was healthy.$

A case of patent ductus arteriosus, attended with a peculiar diastolic murmur / by C. Hilton Fagge, M.D.

Licence and re-use

Contents