File:Diseases of the heart and thoracic aorta (1884) (14781756061).jpg

Identifier: diseasesofheart00bram (find matches)
Title: Diseases of the heart and thoracic aorta
Year: 1884 (1880s)
Authors: Bramwell, Byrom, Sir, 1847-1931
Subjects: Heart Diseases Aortic Diseases Heart Aorta Aorta, Thoracic
Publisher: Edinburgh, Pentland
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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more or less dilated, thedilatation being sometimes general and uniform, in othercases partial and local; its interior is studded here and therewith hard projecting nodules, some of which have the con-sistency of cartilage, others being hard and dense like bone,the latter, which are in reality calcareous plates, are, for themost part, thin and brittle; fissures, cracks, and small irregularulcers, which communicate with atheromatous foci in thesubjacent tissue, are frequently seen in the interior of theaorta ; not unfrequently the sharp edge of a thin calcareousplate projects through the ruptured lining membrane, and theblood is seen to have made its way into the atheromatouscavities and between the coats of the artery, forming a smalldissecting aneurism. Pathological physiology.— The effect of the atheromatousprocess is to impair the elasticity and resisting power ofthe aortic wall; local or general dilatation of the vessel isconsequently very apt to occur under the influence of the
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V ? TlG. 265.—Section tliroii;^ii the whole lliickncss of tlie anrta in atheroma.( X alwut 40.)I, inner ; 2, middle ; and 3, outer coats ; a, free surface of lining membrane ;b, b, fatty particles ; c, fat crystals ; d, leucocytes surrounding vessel of middlecoat; e, leucocytes in outer coat ; f, outer surface of vessel. _ Symptoms and Physical Signs of AtJieroma. 695 blood-pressure. But the effects of the atheromatous processare seldom limited to the aorta itself ; in many cases theaortic valves are involved, and the peripheral blood-vesselsand coronary arteries similarly affected ; secondary changes(hypertrophy, dilatation, and in some cases mitral incom-petence) are often, therefore, present in the heart.^ Symptoms.—Symptoms may be entirely wanting, and thisis more particularly the case when the disease is confined tothe aorta itself, i.e. when the peripheral vessels are not affected,when the aortic valve is not incompetent, and when thecoronary circulation is not interfered wi

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