. Diseases of the heart and thoracic aorta. ases are occasionally met with,but none have come under my own observation, in which thethoracic aorta is constricted just beyond the point at whichit is joined by the ductus arteriosus Botalli. The constriction seems to be due to the fact that theobliterative process, which closes the ductus arteriosus soonafter birth, passes to, and involves the part of the aorta towhich the ductus arteriosus is attached. In some cases, theconstriction is slight; in others great ; occasionally complete. Pathological physiology.—The effect of the constriction is,of
. Diseases of the heart and thoracic aorta. ases are occasionally met with,but none have come under my own observation, in which thethoracic aorta is constricted just beyond the point at whichit is joined by the ductus arteriosus Botalli. The constriction seems to be due to the fact that theobliterative process, which closes the ductus arteriosus soonafter birth, passes to, and involves the part of the aorta towhich the ductus arteriosus is attached. In some cases, theconstriction is slight; in others great ; occasionally complete. Pathological physiology.—The effect of the constriction is,of course, to interfere with the free passage of the blood fromthe transverse into the descending portions of the aortic those cases in which the constriction is considerable orcomplete, the descending portion of the thoracic and theabdominal aorta and their branches have to be suppliedin a circuitous or roundabout manner ; the innominateand left subclavian arteries, the deep-seated arteries of Coarctation of the Thoracic Aorta. 747. Fig. 298, [From Wals/ie, after an imfuhlislied draiving by CaryiceH.) Fig. 297. a, pulmonary artery ; b, arterial duct; c, arch of aorta ; d, coarctationof aorta ; e, descending aorta ; f, innominate artery ; g, internal mammary artery;h, epigastric artery ; i, i, z, i, deep-seated arteries of neck and intercostals, form-ing together with the internal mammary and epigastric arteries, a collateral circu-lation with the thoracic and abdominal aorta and internal iliacs. Fig. 298. Aorta laid open, showing by probe the amount of constriction. the neck, the superior intercostal, internal mammary, andepigastric arteries become enormously enlarged, and thecirculation is carried on through the inosculations which areso well represented in figs. 297 and 298, 74^ Diseases of the Heart. Symptoms.—In those cases in which the constriction issHght, there may be no symptoms. When the constriction isgreat, dyspnoea, cough, haemoptysis, and vertigo, are the
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectheart, bookyear1884
