Case of a small aneurysm of the first part of the arch of the aorta, opening into the pulmonary artery and conus arteriosus of the right ventricle : with remarks on the general subject / by Sir William T. Gairdner, M.D., K.C.B., F.R.S., Physician to the Western Infirmary, Glasgow.

  • Gairdner, W. T. (William Tennant), Sir, 1824-1907.
Date:
[1899]
Catalogue details

Licence: Public Domain Mark

Credit: Case of a small aneurysm of the first part of the arch of the aorta, opening into the pulmonary artery and conus arteriosus of the right ventricle : with remarks on the general subject / by Sir William T. Gairdner, M.D., K.C.B., F.R.S., Physician to the Western Infirmary, Glasgow. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    given way on the left side, rather to the left of the cardiac apex ” (and therefore not precisely in the situation of the actual rupture); the feeling, however, was not one of local pain, but attended by faintness and cold sweat, succeeded almost immediately by the swelling and the other phenomena observed. There were in this case loud murmurs (V.S. and Y.D. in rhythm) heard over the whole front, but with mainly the distribution of the aortic double murmur. No considerable doubt was in this case entertained of the existence of an aneurysm involving the vena cava, the diagnosis being after- wards verified by post-mortem examination. The clinical facts in this case were very completely, though concisely, stated in the article alluded to; but it is obvious that when an opening takes place into the pulmonary artery or right ventricle, the localization of the anasarca as above described, is not to be expected, and the diagnosis is therefore, or at least may be, much more difficult. [See paragraph appended to this article, page 17.] The following case, therefore, having been most carefully recorded with a view to clinical teaching, and having been under observation for a sufficient time to be re- peatedly observed and considered with a clinical class, appears to be a fitting contribution to the Glasgow Hospital Reports. I am greatly obliged to my friend and old pupil, Dr. Alexander Macphail, for his admirable drawings of the preparation now in the museum of the Western Infirmary, which will allow all the facts that can be brought under the eye of the reader to be vividly presented, in connection with the clinical history of the case. The report in the journal, however (Ward I., A., p. 213), is so lengthy that it will be necessary to resort to a summary which, it may be said, is verbatim the one that was recorded and placed before the clinical class, soon after the admission of the patient, in order to facilitate remarks at lecture, and to guide as accurately as possible the conceptions of the members of the class as to the presumptive diagnosis. “ Wm. G. L., aet. 35, engineer; admitted 16th March, 1896. Cardiac lesion of remarkably obscure origin, possibly of about twelve months’ standing on admission ; but, if so, character- ized only by a certain amount of breathlessness and dis-