File:Diseases of the chest and the principles of physical diagnosis (1920) (14777495101).jpg

Identifier: diseasesofchestp1920norr (find matches)
Title: Diseases of the chest and the principles of physical diagnosis
Year: 1920 (1920s)
Authors: Norris, George William, 1875-1965 Landis, Henry R. M. (Henry Robert Murray), 1872-1937, joint author Krumbhaar, E. B. (Edward Bell), 1882-1966
Subjects: Chest Diagnosis Thoracic Diseases Diagnosis
Publisher: Philadelphia, W. B. Saunders company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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Fig. 409.—Patulous but incompetent foramen ovale. (Pennsylvania Hospital.) If, however, the opening is widely dilated it may be considered as beinganomalous and in such cases serious disturbances in the circulation are aptto occur. The fact that the channel runs obliquely through the auricularseptum, and that, therefore, the openings on the two sides are not directlyopposite to each other, favors competency. A demonstrable opening wasrecorded in only 86 cases among 8640 autopsies (0.9 per cent.) at the Phila-delphia General Hospital (Norris). Patency of the foramen ovale may occur alone but it is frequentlyassociated with other defects and particularly with pulmonary stenosis. CONGENITAL HEART DISEASE 759 Symptoms and Physical Signs.—Small openings are not apt to giverise to either signs or symptoms and even a wide opening (see Fig. 416)may exist without manifesting itself during life. In a well-marked ease
Text Appearing After Image:
Fig. 410.—Patulous foramen ovale. Heart of a woman aged seventy years, who diedof croupous pneumonia, having advanced general arteriosclerosis. The illustration showsa chronic, more or less diffuse, mitral thickening, with contraction of the chordese tendinese,and marked hypertrophy of the left ventricle. The foramen ovale is quite large and patu-lous, but owing to its oblique course it was probably functionally competent. the symptoms may be those of congenital disease, namely, cyanosis,dyspnea, often paroxysmal in character, cold extremities, inertia, etc.The murmur may be systohc, diastohc or presystolic in time and is 760 DISEASES OF THE PERICARDIUM, HEART, AND AORTA best heard in the third interspace to the left and close to the sternum.If cyanosis is present constantly or only intermittently, a patent foramenovale may be suspected as the cause of the murmur. Tortuosity and in-equalities of the retinal vessels may be present.

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