Cardiac fibrosis as a result of coronary obstruction / by G. A. Gibson and Robert Muir.

  • Muir Robert, Sir, 1864-1959.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Cardiac fibrosis as a result of coronary obstruction / by G. A. Gibson and Robert Muir. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    from the endocardium. In this fibrous tissue, which was for the most part of very dense character, there were visible merely the pigmented remains of muscle fibres and a few blood vessels,—arteries and wide veins. Fibrous tissue was seen at places spreading inwards irregularly and diffusely between the degenerated muscle fibres to the endocardium, and also running outwards along the intermuscular planes as more distinct bands which also invaded the muscle bundles. This fibrous overgrowth reached its maximum at the anterior branch of the coronary artery (mentioned above), where the dense layer came right up to the surface of the heart, so that at this part the wall was fibrous in its whole thickness, with the exception of a layer of degenerated muscle on the inner aspect (Plate XI., Fig. 1). Here also the wall was thinnest. The most marked degenerative changes were found in the innermost part of the wall, i.e. internal to the dense fibrous layer. In fresh sections the muscle fibres there showed extensive granular degeneration and disintegration, some of which was fatty in nature, and at places, amongst the fibrous tissue, appeared simply as rows of granules or small globules. The degeneration was also marked in the papillary muscles, which also showed fibrous thickening here and there on their surface. These parts, in sections cut in paraffin, showed shrivelled muscle fibres, which appeared as if they had lost their sarcous substance, only a sort of envelope remaining, and which, with the rubin and orange stain, were coloured only a faint pink instead of the usual deep orange (Plate XI., Fig. 1, d). Immediately superficial to the fibrous planes, muscle fibres could be seen of nearly normal appearance, but, at places, of extreme tenuity, with thin fibrous bands spread- ing between them (Plate XI., Fig. 2). But an interesting fact is, that at some places it was quite evident that an extreme atrophy of the fibres preceded and was not caused by the fibrous overgrowth. At no place was there any collection of necrosed fibres, such as are seen in infarcts in the heart wall. Beneath the epicardium the muscle appeared fairly healthy, some of the fibres, however, appearing rather hypertrophied and their nuclei large and somewhat vacuolated. (Plate XI., Fig. 1, b). The condition of the arteries, always an important point