Heart disease and aneurysm of the aorta, with special reference to prognosis and treatment.

  • Broadbent, W. H. (William Henry), Sir, 1835-1907.
Date:
1906
Catalogue details

Licence: In copyright

Credit: Heart disease and aneurysm of the aorta, with special reference to prognosis and treatment. Source: Wellcome Collection.

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

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    last scon, in 1005, slio said slu! did not feel any s|n'(:ial iricdnvonionce from the aneurysni. 'I'lici-o was tlien a jnilsalinj^ Linnoiir alioiil llie size of alien's egf? in the second and third rif^ht intercostal spaces, not ])ro- jectint^ very iiiucli above tlic surface of lli(^ cliest wail. A jreneral lieave was connnunicated to tlie cliest wall around tliis area, and pulsation could be felt by deep j)ulpation in the second and third sj)aces as far as the-anterior axillai-y line, over which area tliere was dulncss on percussion. t)n ])alpation over tlie aneurysm, a well-marked diastolic shock was felt. Tlie aortic second sound was low pitched and ringin;^, and a diastolic murmur was also audible. There was no evidence of pressure on the superior vena cava, no difference in the pulses, no affection of tlie vocal cords, 'i'he pulse wave was forcible and sudden in character, but was sustained instead of collapsing, and presented the characters of the pulse of aortic incom- petence scarcely modified by the .aneurysm. This is practically a case of cured aneurysm. The walls of the sac have become thick and strong from deposit of laminated clot within and chronic inflammatory changes without, and there is little chance of rupture. She has now survived fifteen years from the onset of the aneurysm, and seldom has any symptoms to remind her of its existence. (3) Aneueysm of the Tbansveese Paet of the Aech. Aneurysm of Symptoms. The name, aneurysm of symptoms, has been given to aneurysms affecting the transverse part of the arch because, as a rule, characteristic and important symptoms early arise which engender a suspicion of aneurysm some time before the physical signs are at all demonstrative of its existence. Most of the symptoms which may arise Imve already been enumerated under the head of Pressure Symptoms; but, for the sake of clearness, it will be necessary to briefly discuss them here. The symptoms will vary, and one or. other of them will present themselves according as the aneurysm is situated in the convexity or concavity of the arch, or upon its anterior or posterior surface. 1. Pressure on the Left Recurrent Laryngeal Nerve.—