. The diseases of infancy and childhood : designed for the use of students and practitioners of medicine. r (foramen ovale); ventricular. 2. Pulmonary Artery.—Stenosis of the conus, trunk, or ostium(a) simple cases (before the end of the first year of life); (6) com-plicated cases with open foramen ovale or ductus arteriosus, defect ofthe ventricular .septum, or transposition of the great vessels. 666 DISEASES OF THE CIRCULATORY SYSTEM 3. Aortic Valve Stenosis or (reiieral Contraction of the Aortic Si/stem.—The first may be due to developmental defect or to fetal endocarditis;the second, to de
. The diseases of infancy and childhood : designed for the use of students and practitioners of medicine. r (foramen ovale); ventricular. 2. Pulmonary Artery.—Stenosis of the conus, trunk, or ostium(a) simple cases (before the end of the first year of life); (6) com-plicated cases with open foramen ovale or ductus arteriosus, defect ofthe ventricular .septum, or transposition of the great vessels. 666 DISEASES OF THE CIRCULATORY SYSTEM 3. Aortic Valve Stenosis or (reiieral Contraction of the Aortic Si/stem.—The first may be due to developmental defect or to fetal endocarditis;the second, to developmental defect. All aortic conditions anomalousin character have, so far as is known, not been diagnosed duringchildhood. 4. Valvular Anomalies.—Valvular anomalies of the semilunar valves,due to fetal endocarditis or developmental irregularities are of purelyscientific interest. .5. Open Ductus Arteriosus or Botalli.—(a) Simple; (6) combinedwith septum defects or pulmonary stenosis. 6. Transposition of the Heart and Congenital Anomalies of the Peri-cardium (of purely scientific interest).. Fig. 175.—Clubbed fingers of congenital heart disease. Child, aged six years. From the above account, which I have modified for practical usefrom the classification of Vierordt, it will be seen that only the con-genital anomalies of the auricular ventricular septum, the pulmonarvartery, and the ductus arteriosus Botalli are of interest to the cliniciari Stenosis of the Puhnonary Artery, Conus, or Ostium.—This is themost common of all congenital heart lesions. If found after thethirteenth month of life, it is in most cases combined with a congenital DISEASES OF THE HEART 667 deficiency of the septum ventriculorum. Rauchfuss found a simplestenosis in only 10 per cent, of all the published cases. Most of thecases are due to fetal endocarditis. Physical Signs.—Simple Stenosis.—Simple stenosis of the artery,conus, or ostium, found only before the thirteenth month (Rokitansky).
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