Splanchnicectomy in relation to hypertensive disease of pregnancy

ABSTRACTS,

THIRD INTER-AMERICAN

CARDIOLOGICAL

CONGRESS

THE EFFECT OF A LOW FAT DIET ON THE SPONTANEOUSLY CURRING ARTERIOSCLEROSIS OF THE CHICKEN.-Lorrrs LICK, M.D., AND LOUIS N. KATZ, M.D., CHICAGO, ILL. To be published in full in American Heart Jourml.

631

O(:Hour-

SPLANCHNICECTOMY IN RELATION TO HYPERTENSIVE DISEASE OF PREGNANCY.-EMIL R,I. ISBERG, 5’I.D.. AND Max M. PEET, M.D.. A&~

ARBOR,

MICH.

The large number of hypertensive women who were treated by splanchnicectomy, at the University of Michigan Hospital presented the opportunity to investrgate several aspects of the incompletely understood entity of hypertensive disease of pregnancy-, especially in its relation to the autonomic nervous system and the operation of bilateral supradiaphragmatic splanchnicectomy. The findings of this study strongly suggest that the surgical procedure of splanchnicectomy is worthy of being utilized in the management of some of the problems of hypertensive disease of pregnancy for the following reasons: 1. Not a single one of eighteen hypertensive women who responded to splanchnicectomy by maintaining normal blood pressure IeveIs after operation and who subsequently became pregnant developed a toxemia of pregnancy. 2. Two casesof toxemia superimposed upon prepregnant hypertension and operated upon during pregnancy responded dramatically to splanchnicectom\r, with prompt disappearance of the toxemias and the achievement of normal blood pressure levels for the remainder of the pregnancies and during a long po>tpartum follow-up period. 3. Women whose hypertension was first recognized during pregnansc manifested a better response to splanchnicectomy than did women whose ht-pertensive disease bore no relation to pregnancy, even though the clinical pi&rc~s of the two groups are alike prior to operation. HEART

DISEASE

OF PREGNANCY.-Jurors

JENSEN,

M.D.,

ST.

I,our5.

MO.

The paper considers the pathological effects of pregnancv on the cardiovascular system. Evidence has been accumulated in the literature recent 1) that pregnancy, as such, may have effects on the myocardium which lead to the development of definite pathological changes in the heart muscle and, clinically, to congestive heart failure, which may occur during pregnancy, with or without association with hypertension, and also post partum. It is possible that this process is related to changes in the blood pressure and in the electrocardiogram which are sometimes seen associated with childbearing. Several personal experiences, including electrocardiographic observat iorrs. form the original contribution to this subject. .4CTI\7E PARTICIPATION OF THE ARTERIAI, WL4LL IN AK’I‘Etil;\l, PRESSTiRE ADJUSTMENT.-C. JIM~NEZ-D~.IZ. M.D., P. BARREDA, 3l.D., ,\ND ,4. F. MOLINA, M.D., MADRID, SPAIN. Stimulation of the central end of the vagi is used as a test to produce sharp arterial hypertension in, the anesthetized dog. This effect is not suppressed even when the pituitary gland, the kidneys, and the adrenals are removed. C’onversely, it disappears when the cervical spinal cord is sectioned. It is, therefore, the result of a reflex whose afferent path is the sensitive vagus, and whose efferent path is the svmpathetic nerves. The humoral nature of the sympathetic action on the arterial wall is shown in crossed-circulation experiments, with simultaneous hypertension in the receptor dog when the vagi are stimulated in the