File:Diseases of the heart and arterial system - designed to be a practical presentation of the subject for the use of students and practitioners of medicine (1907) (14589663310).jpg

Identifier: diseasesofhearta1907babc (find matches)
Title: Diseases of the heart and arterial system : designed to be a practical presentation of the subject for the use of students and practitioners of medicine
Year: 1907 (1900s)
Authors: Babcock, Robert H. (Robert Hall), b. 1851
Subjects: Heart Arteries Heart Diseases Arterial Occlusive Diseases
Publisher: New York and London : D. Appleton and Company
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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, properly speaking, do not form a part of the clinicalhistory of thoracic aneurysms. They may be present nevertheless,and are then the result, in part at least, of the stasis within theportal system and its tributaries occasioned by pressure on thegreat veins in the thorax. All aneurysms of the arch do not occasion appreciable inter-ference with the flow of blood out of the venous system. When,however, an aneurysm attains considerable size it can scarcely failto affect circulation by mechanical pressure. One or both ofthe vense cava? may be compressed, and to such a degree that thecirculation can only be carried on by means of collateral vessels. Such a condition is admirably shown in Fig. 110, which is takenfrom a photograph kindly furnished me by Dr. Emil Beck. Thisman, aged thirty-seven, was first seen by Dr. Beck in October of1901, at which time his complaint was of cough, dyspnoea and in-ability to lie down. He gave a history of syphilis sixteen years50 786 DISEASES OF THE HEART
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Fig. 110.—Dilatation of Superficial Veins Secondary to Pressure by Aneurysm on Ven^e Cav^e. before, for which he received very inadequate treatment. His occu-pation was that of a metal-polisher, which necessitates the puttingforth of considerable strength in pressing the metal against a ANEURYSM OP TIIK THORACIC AORTA VST polishing wheel. Here, then, were two factors 1 >»h operative inthe etiology of aneurysm. His one initial sympl of breathlessness on exertion devel-oped slowly, and did not necessitate abandonment of work and thesport of playing baseball until nearly a year after it was firstnoticed. When Dr. Deck examined the patient there was a per-ceptible fulness of the neck and bulging in the aortic area. Thistumour pulsated and gave a systolic bruit. The pulses of the righthalf of the neck and of the corresponding arm were distinctlysmaller than their fellows on the left side. The diagnosis wasaccordingly made of aneurysm of the ascending and transverseaorta. Cyan

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