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On congenital isolated dextrocardia
-
Department
of Reviews Selected
R@&r, 505,
Hugo: 1930.
On Congenital
Isolated
and Abhds
S
Abstracts Dextrocardia.
Wicn.
Arch.
f. inn.
Med.
19:
This paper contains a very extensive and complete discussion on the snbject baaed upon a thorough search of the literature from which the author has collected 38 cases verified by autopsy and 126 cases not so verified, but the author Strews because otherwise partial situs inversus the importance of anatomical verification, cannot be excluded. In the first case there was an The author describes his own seven cases. isolated inversion of the ventricles and the large trunks as well as a transposition The second case was remarkably free of the aorta alone into the right ventricle. from s3’mptoms, the third had peripheral malformations. On x-ray three eases had high dextropc.sition, twice there was a mirror-position of the heart, five times atypical shape of the cardiac shadow. In five cases the left diaphragm was higher than the right. One electrocardiogram was narmal, one was diverted, one cornpletely atypieal, two had negative T-waves. The 38 cases verified by autopsy are described and iuterpreted. The average age K:M eleven years, and various cardiac malformations were frequent and there were cases with situs solitus (the heart alone being transposed) combined with normal 01 transposed origin of the great vessels. The isolated congenital dextrocardia is not a malformation sui generis. No case is known with trausposition of all parts of the heart and no rase is known in which the heart and the great vessels were not malformed. In the 126 cases described clinically the average age wa.s 23% years. Great exercise tolerance was noted in many of these cases. In many there were other malformations, especially defects in the muscles to the ribs. The apex heat was well demarcated, diffuse or even impalpable. seventy-five cases had x-ray photo graphs, some had mirror pictures, others had atypical shadows. In the mirror forms the high dextroposition of the aorta predominates, in the atypical shadow forms the normal leftsided position. In most cases the right diaphragm was low, this dieerenee between the diaphragms being caused by the cardiac position anll not by the liver. Twebty-nine electrocardiograms were obtained, S were normal, others had negative T-waves, with or without axis deviation. In these eases T-wave abnormalitir,s had no prognostic significance. Q-waves were frequent, probably due to malposition. Disturbanees of rhythm were rare. When the x-ray showed mirror picture, the t:lectrocardiogram was usually inverted, the atypical x-rays (not “mirrored”) would show positive electrocardiograms. The electrocardiographic interpretation was difficult on account of lack of material for verification, the anatomical relations being so very complicated and even the conduction system might be abnormal. In a few eases it is possibIe for the patients to obtain a high ‘age without impairment of cardiac function, but as a rule the prognosis is gldomy, About 350 references to the literature are appmML 673
Department
of Reviews Selected
R@&r, 505,
Hugo: 1930.
On Congenital
Isolated
and Abhds
S
Abstracts Dextrocardia.
Wicn.
Arch.
f. inn.
Med.
19:
This paper contains a very extensive and complete discussion on the snbject baaed upon a thorough search of the literature from which the author has collected 38 cases verified by autopsy and 126 cases not so verified, but the author Strews because otherwise partial situs inversus the importance of anatomical verification, cannot be excluded. In the first case there was an The author describes his own seven cases. isolated inversion of the ventricles and the large trunks as well as a transposition The second case was remarkably free of the aorta alone into the right ventricle. from s3’mptoms, the third had peripheral malformations. On x-ray three eases had high dextropc.sition, twice there was a mirror-position of the heart, five times atypical shape of the cardiac shadow. In five cases the left diaphragm was higher than the right. One electrocardiogram was narmal, one was diverted, one cornpletely atypieal, two had negative T-waves. The 38 cases verified by autopsy are described and iuterpreted. The average age K:M eleven years, and various cardiac malformations were frequent and there were cases with situs solitus (the heart alone being transposed) combined with normal 01 transposed origin of the great vessels. The isolated congenital dextrocardia is not a malformation sui generis. No case is known with trausposition of all parts of the heart and no rase is known in which the heart and the great vessels were not malformed. In the 126 cases described clinically the average age wa.s 23% years. Great exercise tolerance was noted in many of these cases. In many there were other malformations, especially defects in the muscles to the ribs. The apex heat was well demarcated, diffuse or even impalpable. seventy-five cases had x-ray photo graphs, some had mirror pictures, others had atypical shadows. In the mirror forms the high dextroposition of the aorta predominates, in the atypical shadow forms the normal leftsided position. In most cases the right diaphragm was low, this dieerenee between the diaphragms being caused by the cardiac position anll not by the liver. Twebty-nine electrocardiograms were obtained, S were normal, others had negative T-waves, with or without axis deviation. In these eases T-wave abnormalitir,s had no prognostic significance. Q-waves were frequent, probably due to malposition. Disturbanees of rhythm were rare. When the x-ray showed mirror picture, the t:lectrocardiogram was usually inverted, the atypical x-rays (not “mirrored”) would show positive electrocardiograms. The electrocardiographic interpretation was difficult on account of lack of material for verification, the anatomical relations being so very complicated and even the conduction system might be abnormal. In a few eases it is possibIe for the patients to obtain a high ‘age without impairment of cardiac function, but as a rule the prognosis is gldomy, About 350 references to the literature are appmML 673