File:Diseases of the chest and the principles of physical diagnosis (1920) (14778271964).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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STENOSIS Etiology.-—This is the rarest of the left-sided valvular lesions. Trueaortic stenosis unassociated with another vah^lar lesion is not oftenencountered. In the autopsy records of the Pennsylvania and Philadel-phia General Hospitals, Norris found 48 instances of aortic stenosis out 1 Sansom and Gibson, Allbtjtt and Rolleston: System of ^Medicine, vol. vi,p. 362. 2 TiCE, F.: The Clinical Determination and Significance of Some PeripheralSigns of Aortic Insufficiencj, Illinois Med. Jour., September, 1911. 740 DISEASES OF THE PERICARDIUxM, HEART, AND AORTA of a total of 9940 cases having cardiac lesions. It is important to bear thisin mind as a systolic murmur at the aortic cartilage is relatively commonand on this evidence alone a diagnosis of aortic stenosis is made far toofrequenth. The interpretation of systolic murmurs heard at the aorticarea has been considered on page 788. The great majority of casesof aortic stenosis are encountered in those past the middle period of life
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Fig. 404.—Aortic obstruction from above. The luaigins of the leaflets are fused to-gether, thickened and calcified, reducing the orifice to about one-third of its normal caliber.The mitral and tricuspid orifices are also sclerosed and contracted. and in those who are the subjects of atheromatous changes in the arteries,especially the aorta. It is rare among women. Occurring as a singlelesion it is not often caused by acute rheumatic fever. Morbid Anatomy.^—The anatomical changes which take place in thesemilunar valves are precisely similar to those which occur in the intimaof the blood-vessels and ending in atheromatous degeneration. As aresult, the leaflets become fused, stiff, and rigid and obstruct the free ENDOCARDITIS 741 escape of the blood from the left ventricle into the aorta (see Fig.404). In some instances the obstruction is made worse by vegetationswhich develop during an attack of secondary endocarditis (see Fig.405). The resistance offered adds to the work of the lef

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