Pediatrics : the hygienic and medical treatment of children . exercise which produces or increases dyspnea, whichproduces a feeling of weakness or a condition of exhaustion, or whichcauses any irregularity in the force and rhythm of the heart beat,should be avoided. With these limitations, the child should bebrought up under the conditions which best conduce to normaldevelopment. DEFECT OF THE INTERVENTRICULAR SEPTUM This anomaly is much less common than stenosis of the pulmonaryartery. It may occur as the only anomaly, but much more often Defective Interventricular Septum 23 it is associated
Pediatrics : the hygienic and medical treatment of children . exercise which produces or increases dyspnea, whichproduces a feeling of weakness or a condition of exhaustion, or whichcauses any irregularity in the force and rhythm of the heart beat,should be avoided. With these limitations, the child should bebrought up under the conditions which best conduce to normaldevelopment. DEFECT OF THE INTERVENTRICULAR SEPTUM This anomaly is much less common than stenosis of the pulmonaryartery. It may occur as the only anomaly, but much more often Defective Interventricular Septum 23 it is associated with other lesions, particularly pulmonary stenosisand transposition of the great vessels. PATHOLOGICAL ANATOMY.—In the majority of cases thedefect is represented by a circular or oval opening of varying size,situated at the base of the interventricular septum just below theorifices of the great vessels. As rare anatomical curiosities areencountered cases in which the interventricular septum is completelyabsent {cor biatriatrum), or rudimentary. Fig. 2i6. S, unclosed ventricular septum. Female lo months old. Warren Museum,Harvard University ETIOLOGY.—This lesion always represents a developmentalanomaly occurring early in fetal life. In cases in which defect ofthe interventricular septum is the only lesion, it represents a primaryfailure of embryonic development, due to the general causes ofdevelopmental malformations. (See page 12). In the majority ofcases, the defect occurs in association with pulmonary stenosis ortransposition of the great vessels. The most satisfactory explanationof the frequent simultaneous occurrence of these lesions is that ofRokitansky, who traces them all to a deviation of the aortic defect of the interventricular septum the opening is caused byfailure of the deviated aortic septum to unite properly with theinterventricular septum. This may also be the cause of the caseswhich apparently represent a primary defect. 24 Diseases of Heart, Per
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectpediatr, bookyear1917
