File:Studies in cardiac pathology (1911) (14777696931).jpg

Identifier: studiesincardiac00norr (find matches)
Title: Studies in cardiac pathology
Year: 1911 (1910s)
Authors: Norris, George William, 1875-1965
Subjects: Cardiovascular System
Publisher: Philadelphia : Saunders
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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, 1 in 8,640. Pathologic Anatomy.—Gtimmatous cardiac disease consists ofcircumscribed tumor-like masses which on section appear dry andyellowish or grayish in color. The lesions are chiefly encounteredin the ventricles, though the auricles, and especially the inter-ventricular septum, are often diseased. The involvement isgenerally multiple, the size ranging from 0.5 cm. upward. Ifbreaking down occurs, cardiac sclerosis or aneurism may result.The gummatous cases are usually accompanied by more or lessdiffuse fibrous change. The gummas show the characteristichistologic structure. They are generally sharply defined andencapsulated. In the fibrous type involvement of the endo-cardium and the pericardium is more frequent than in the gum-matous variety. As might be expected, vascular changes in thecoronary vessels are common findings. Syphilitic endocarditisand pericarditis are generally secondary to myocardial disease.The fibrous type of cardiac sjphilis is essentially a microscopic 200
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Fiu. 71.—.Syphilitic Aortitis. Syphilitic me.saortitis occurs characteristically about one and one half inches above theaortic valves, often spreading downward and involving the mouths of the coronary arteriesand the leaflets secondarily. The surface of the aorta appears depressed—not elevated as inthe ordinary arteriosclerotic lesions. It is a prolific source of aortic aneurism, and aorticrupture. (See Cardiac Syphilis, p. 200, and Diseases of the Aortic Orifice, p. 50.Compare Figs. 41, 66, 72.; 202 STUDIES IN CARDIAC PATHOLOGY lesion. It is of considerable rarity.^ Warthin has describeddiffuse myocardial fibrosis due to congenital syphilis,- and produc-tive mesaortitis as a hereditary lesion has been reported by Bruhns,^Wiesner,* and Klotz. That mesaortitis is frequently the result of syphilis has beenshown by the demonstration of the Spirochoeta pallida in theselesions. The lesion is generally confined to the arch of the aorta,or, as in the case depicted in Fig. 71, extends onl

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