Diseases of the chest and the principles of physical diagnosis . 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, co
Diseases of the chest and the principles of physical diagnosis . 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, 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 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 Fig. 411.—Patulous interventricular septum with acute endocarditis. In the septumventriculorum, just to the left of the beginning of the conus arteriosus, there is an ovalopening, X cm. in diameter, which appears as a funnel-shaped excavation in theventricular septum. The opening into the left ventricle is nearly closed by large wart-likevegetations. These vegetations extend from the opening upward into the conus arteriosusand are continuous with those in the right anterior leaflet of the pulmonary valve. Imperforate Ventricular Septum.—A very common congenital defectis an abnormal communication between the two ventricles. The perfora-tion usually occurs just beneath the aortic orifice, in the membranous CONGENITAL HEART DISEASE 761 or undefended space, so-called because normally the septum here consistsof two layers of endocardium. In the majority of instances this defectoccurs in association with other anomalies. In 78 per cent, of Abbottscases it appeared in
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1920
