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The heart rate in malaria; a review of 90 cases
522
AMEKICAN
HEART
JOURNAL
suggested as an important means for differentiating the pain of acute coronary occlusion from that of acute dissecting aneurysm. Tears in the aortic intima, classified as initial, were located in the Sixteen presented evidence of being recent, the other three upper aorta in nineteen instances. appeared to be well healed and communicated with dissected endothelialized aneurysmal sacs. Eleven of the nineteen initial intimal tears were located within the first 3 cm. of the ascending aorta, six in the ascending aorta beyond the 3 cm. level, one in the arch, and the remaining example in the thoracic aorta. It was more difficult to identify the site of the rupture of the adventitia, through which blood escaped from the sac into the surrounding tissues or serous cavities. Rerupture of the dissecting aneurysmal sac into the original lumen was discovered in six instances, in two of which the secondary tear had occurred in the abdominal portion of the aorta and in the other four in one of the iliac arteries. Considering involvement of the main branches of the aorta in the dissecting process in order of frequency, the iliac arteries were affected in eight cases, the great vessels of the arch in six, the renal arteries in six, the celiac axis in five, the mesenteric arteries in five, and the coronary arteries in three cases. An arteriosclerotic involvement of some part of the aorta was described in every case. Medionecrosis, which is now recognized as being by far the main etiological factor of dissection of the aorta, was found in thirteen cases; it was not typical in two cases and was absent in the other two cases. Nine patients died within twenty-four hours and six within one to six days following the onset of the aortic dissection. A healed dissecting aneurysm which had developed previously, was noted at necropsy in three of the cases. The immediate cause of death was acute dissection of the aorta in only two cases, whereas in the remainder, it was hemorrhage into the pericardial sac with resultant cardiac tamponade. &‘ENDKOS.
Mellinkoff, Ann.
Int.
S. M., Med.
and Higgins, J. R. : 27:433 (Sept.), 1947.
The
Heart
Rate
in Malaria;
a Review
of 90 Cases.
The authors studied the heart rate during bouts of pyrexia in ninety cases of malaria, confirmed by the identification of the parasite in thin or thick blood smears. Of these, eighty-five were examples of infection with Plasmodium vivax, two with Plasmodium falciparum, and three with Plasmodium malariae. The results of the study indicated that one-fourth of the patients had a relative bradycardia, which, however, was never less than 70 per minute. \f’SNDSOS.
Solarz,
S. D.: Paroxysmal
So-called Tachycardia.
“Infarction Ann.
Int.
Type” Med.
Electrocardiographic 27:447 (Sept.),
Changes
Following
1947.
The author describes a case of a 40-year-old aviator whose electrocardiograms for a twoweek period following cessation of an attack of paroxysmal tachycardia showed varying degrees of abnormality in the form of the T waves in the conventional limb and CF leads. No explanation for the 1‘ wave changes is offered, but the author discards the possibility that myocardial infarction or quinidine effects were responsible. ~IIENDKOS.
Gordon, I. : Mechanism 44:247 (Sept.), 1947.
of
Lipophage
Deposition
in
.4 therosclerosis.
Arch.
Path.
The author reviewed and commented on the present knowledge and theories concerning the pathogenesis of atherosclerosis. He believes tha’t Leary’s work is the final link in a chain of evidence that began many years ago with the development of alimentary hypercholesteremia in rabbits. After cholesterol ingestion by these animals, the cells of the reticuloendothelial system take up the esteriiied cholesterol and then become detached, entering the blood stream and infiltrating the i&ma of the aorta. Gordon objects to the term emphasizes the old physiologic peripheral zone in the circulating
“chemotaxis” as an explanation of this infiltrating process, but concept of a heavy central cellular concentration with a clear The endothelial cells filled with cholesterol, column of blood.
AMEKICAN
HEART
JOURNAL
suggested as an important means for differentiating the pain of acute coronary occlusion from that of acute dissecting aneurysm. Tears in the aortic intima, classified as initial, were located in the Sixteen presented evidence of being recent, the other three upper aorta in nineteen instances. appeared to be well healed and communicated with dissected endothelialized aneurysmal sacs. Eleven of the nineteen initial intimal tears were located within the first 3 cm. of the ascending aorta, six in the ascending aorta beyond the 3 cm. level, one in the arch, and the remaining example in the thoracic aorta. It was more difficult to identify the site of the rupture of the adventitia, through which blood escaped from the sac into the surrounding tissues or serous cavities. Rerupture of the dissecting aneurysmal sac into the original lumen was discovered in six instances, in two of which the secondary tear had occurred in the abdominal portion of the aorta and in the other four in one of the iliac arteries. Considering involvement of the main branches of the aorta in the dissecting process in order of frequency, the iliac arteries were affected in eight cases, the great vessels of the arch in six, the renal arteries in six, the celiac axis in five, the mesenteric arteries in five, and the coronary arteries in three cases. An arteriosclerotic involvement of some part of the aorta was described in every case. Medionecrosis, which is now recognized as being by far the main etiological factor of dissection of the aorta, was found in thirteen cases; it was not typical in two cases and was absent in the other two cases. Nine patients died within twenty-four hours and six within one to six days following the onset of the aortic dissection. A healed dissecting aneurysm which had developed previously, was noted at necropsy in three of the cases. The immediate cause of death was acute dissection of the aorta in only two cases, whereas in the remainder, it was hemorrhage into the pericardial sac with resultant cardiac tamponade. &‘ENDKOS.
Mellinkoff, Ann.
Int.
S. M., Med.
and Higgins, J. R. : 27:433 (Sept.), 1947.
The
Heart
Rate
in Malaria;
a Review
of 90 Cases.
The authors studied the heart rate during bouts of pyrexia in ninety cases of malaria, confirmed by the identification of the parasite in thin or thick blood smears. Of these, eighty-five were examples of infection with Plasmodium vivax, two with Plasmodium falciparum, and three with Plasmodium malariae. The results of the study indicated that one-fourth of the patients had a relative bradycardia, which, however, was never less than 70 per minute. \f’SNDSOS.
Solarz,
S. D.: Paroxysmal
So-called Tachycardia.
“Infarction Ann.
Int.
Type” Med.
Electrocardiographic 27:447 (Sept.),
Changes
Following
1947.
The author describes a case of a 40-year-old aviator whose electrocardiograms for a twoweek period following cessation of an attack of paroxysmal tachycardia showed varying degrees of abnormality in the form of the T waves in the conventional limb and CF leads. No explanation for the 1‘ wave changes is offered, but the author discards the possibility that myocardial infarction or quinidine effects were responsible. ~IIENDKOS.
Gordon, I. : Mechanism 44:247 (Sept.), 1947.
of
Lipophage
Deposition
in
.4 therosclerosis.
Arch.
Path.
The author reviewed and commented on the present knowledge and theories concerning the pathogenesis of atherosclerosis. He believes tha’t Leary’s work is the final link in a chain of evidence that began many years ago with the development of alimentary hypercholesteremia in rabbits. After cholesterol ingestion by these animals, the cells of the reticuloendothelial system take up the esteriiied cholesterol and then become detached, entering the blood stream and infiltrating the i&ma of the aorta. Gordon objects to the term emphasizes the old physiologic peripheral zone in the circulating
“chemotaxis” as an explanation of this infiltrating process, but concept of a heavy central cellular concentration with a clear The endothelial cells filled with cholesterol, column of blood.