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The size of the heart in goiter. A teleroentgenographic study
Department
of Reviews Selected
and Abstracts
Abstracts
A Standardized Procedure Gross, Louis, Antopol, William, and Sacks, Benjamin: Suggested for Microscopic Studies on tie Heart. Arch. Path. 10: 810, 1930. The authors have tlevelopcd a procedure for cutting blocks of heart muscle tissue which show a maximum number of lesions in a minimum number of blocks. The six blocks include the four valves, the four valve rings, the pericarthe heart, the left and right auricles, the dium of the left and right sides, myocardium of the left ventricle, right ventriele, inter\rcntricular septum and left posterior papillary muscle; the bases of the aorta and pulmonary artery; the pericardial wedges abutting against the valve rings; the neuromuscular bundle, and the coronary sinus. It is pointed out that the myocardium in practically every section is taken from a site where the vcsscls can be considered end vessels. It is probably for this reason that early vascular changes and their results are so frequently observed in these sections, and that inflammatory lesions, which may possibly owe their localization to the fact that the vessels in this region are terminal, are so frequently found here. By using these sections only, the authors have been able to find Aschoff bodies in 90 per cent of 40 hearts showing acute verrucous endocarditis and in 15 per cent of 39 hearts showing chronic valvular disease. In some of the hearts not showing these lesions, sections from other parts were taken as well, but failed to show Aschoff’s bodies.
Middleton, canlium.
William Am.
S., and Oatway, J. M.
SC. 181:
William
H.:
Insulin
Shock and the Myo-
39, 1931.
The authors have studied the changes occurring in the heart of 11 patients during insulin shock. They have observed the establishment of common changes in certain of the component waves of the electrocardiogram and to less common but more serious errors in conduction during insulin shock. Because of the gravity of the changes noted in the presence of myocardial lesions, particular caution is enjoined in the use of insulin in such patients. Where any question exists, the avoidance of hypoglycemia must be insured by an adequate coverage of insulin through concomitant intravenous glucose injections even though there is no agreement as to the causal relationship of the depressed blood sugar.
Hurxthal, Goiter.
Lewis M.; Menard, 0. J.; Bogan, M. E.: The Size of the Heart A Teleroentgenographic Study. Am. J. M. SC. 180: 772, 1930.
in
Teleroentgenograms were made on one hundred consecutive cases of toxic and one hundred consecutive cases of nontoxic goiter, No difinite relationship could be found between the duration of the disease or weight loss and the size of the heart. Cardiac enlargement as determined by teleroentgenography showed a fairly direct relationship to age and coincident cardiovascular disease.
575
Cotton, Thomas F.: 1: 481, 10.11.
The Treatment
of
Mitral
Disease
in
Children.
Brit.
-\I.
J.
The author has selected the first one huudrctl boys admitted to a convalescent heart disease. The after cardiac home in the years 1919 to lP,,Oi’ with rheumatic histories of all hut six of these have been obtaiued after seven years in one’ group and eight years in another. All have had rheumatism or chorea and all but two Fifty-scvcn wivrvre diagnosed hare had signs of a rheumatic infection of the heart. as having mitral disease, tweuty.thrre mitral stenosis, fourtrru mitral stenosis and sortie regurgitation aud four had aortic regurgitation alone. The author belicres that mitral disease iu cllildreu with a rheumatic invasion of the myocardium and is end of seven years, 17 or 29 per cent were dead. stenosis or fiS per cent. were dead after 8 years. In 14 cases of mitral stenosis and aortic regurgitatinu, S years.
is probably evidence of Fifteen of the smallest six of whom
always associated At the rarditis. those with mitral group there were were dead after
From a study of tllis groul’ it seems permissible to state that the prognosis in children with mitral stenosis over a period of eight years who have had careful lrcatment in a special convalescent home is a grave one. They raise the question of this form of treatment in mitral strnosis and whether it is worth while treating such casts in a special convalescent home. The treatmeut of children with chronic rheumatism is unsatisfactory when the;! belong to the poorer classes. On leaving the convalescent home where they have been more or less protected against reinfection they rcturu to unhealthy homes and are again exposed to rheumatic and other infections which cause more damage to the heart muscle and valves. The children of well-to-do persons are better protected against the ravages of rheumatism for they have home surroundings in which they can live, grow up and be educated under conditions which arc comparable to those which exist. in a special convalescent home. The prognosis is more favorable in these children because the disease is likely to be recognized in its early stages and suitable treatment given at a time when it is possible to prcvcut the development of progressive changes leading to :I serious cardiac disability. Slater,
Solomon
matic Fever.
IL: Am.
The Involvement J. hf. SC. 181:
203,
of the 1031.
Coronary
Arteries
Three cases of adults with acute rheumatic fever are cited electrocardiographic evidence of coronary arterial involvement. acute coronary closure was also suggested strongly by the pericardial friction rub, leurocytosis and fercr. It seemed none of tire brunt the endocardium received practically rheumatic virus. All three patients recovered.
in
Acute
Rheu-
in detail which showed The diagnosis of symptoms of collapse, that in all three cases of the attack of the
rheumatic infection any blood vessel, It is emphasized that during an acute large or small may possibly be involved and that those of the heart may likewise be involved; that when the larger coronary branches are affected under certain circumstances it may be suflicient to encroach so upon the lumen as to occlude it.; or a thrombus may occur secondarily producing a closure. When the closure cmurs, the patients experience cscruCiating pains indieativc of the lesion.
of Reviews Selected
and Abstracts
Abstracts
A Standardized Procedure Gross, Louis, Antopol, William, and Sacks, Benjamin: Suggested for Microscopic Studies on tie Heart. Arch. Path. 10: 810, 1930. The authors have tlevelopcd a procedure for cutting blocks of heart muscle tissue which show a maximum number of lesions in a minimum number of blocks. The six blocks include the four valves, the four valve rings, the pericarthe heart, the left and right auricles, the dium of the left and right sides, myocardium of the left ventricle, right ventriele, inter\rcntricular septum and left posterior papillary muscle; the bases of the aorta and pulmonary artery; the pericardial wedges abutting against the valve rings; the neuromuscular bundle, and the coronary sinus. It is pointed out that the myocardium in practically every section is taken from a site where the vcsscls can be considered end vessels. It is probably for this reason that early vascular changes and their results are so frequently observed in these sections, and that inflammatory lesions, which may possibly owe their localization to the fact that the vessels in this region are terminal, are so frequently found here. By using these sections only, the authors have been able to find Aschoff bodies in 90 per cent of 40 hearts showing acute verrucous endocarditis and in 15 per cent of 39 hearts showing chronic valvular disease. In some of the hearts not showing these lesions, sections from other parts were taken as well, but failed to show Aschoff’s bodies.
Middleton, canlium.
William Am.
S., and Oatway, J. M.
SC. 181:
William
H.:
Insulin
Shock and the Myo-
39, 1931.
The authors have studied the changes occurring in the heart of 11 patients during insulin shock. They have observed the establishment of common changes in certain of the component waves of the electrocardiogram and to less common but more serious errors in conduction during insulin shock. Because of the gravity of the changes noted in the presence of myocardial lesions, particular caution is enjoined in the use of insulin in such patients. Where any question exists, the avoidance of hypoglycemia must be insured by an adequate coverage of insulin through concomitant intravenous glucose injections even though there is no agreement as to the causal relationship of the depressed blood sugar.
Hurxthal, Goiter.
Lewis M.; Menard, 0. J.; Bogan, M. E.: The Size of the Heart A Teleroentgenographic Study. Am. J. M. SC. 180: 772, 1930.
in
Teleroentgenograms were made on one hundred consecutive cases of toxic and one hundred consecutive cases of nontoxic goiter, No difinite relationship could be found between the duration of the disease or weight loss and the size of the heart. Cardiac enlargement as determined by teleroentgenography showed a fairly direct relationship to age and coincident cardiovascular disease.
575
Cotton, Thomas F.: 1: 481, 10.11.
The Treatment
of
Mitral
Disease
in
Children.
Brit.
-\I.
J.
The author has selected the first one huudrctl boys admitted to a convalescent heart disease. The after cardiac home in the years 1919 to lP,,Oi’ with rheumatic histories of all hut six of these have been obtaiued after seven years in one’ group and eight years in another. All have had rheumatism or chorea and all but two Fifty-scvcn wivrvre diagnosed hare had signs of a rheumatic infection of the heart. as having mitral disease, tweuty.thrre mitral stenosis, fourtrru mitral stenosis and sortie regurgitation aud four had aortic regurgitation alone. The author belicres that mitral disease iu cllildreu with a rheumatic invasion of the myocardium and is end of seven years, 17 or 29 per cent were dead. stenosis or fiS per cent. were dead after 8 years. In 14 cases of mitral stenosis and aortic regurgitatinu, S years.
is probably evidence of Fifteen of the smallest six of whom
always associated At the rarditis. those with mitral group there were were dead after
From a study of tllis groul’ it seems permissible to state that the prognosis in children with mitral stenosis over a period of eight years who have had careful lrcatment in a special convalescent home is a grave one. They raise the question of this form of treatment in mitral strnosis and whether it is worth while treating such casts in a special convalescent home. The treatmeut of children with chronic rheumatism is unsatisfactory when the;! belong to the poorer classes. On leaving the convalescent home where they have been more or less protected against reinfection they rcturu to unhealthy homes and are again exposed to rheumatic and other infections which cause more damage to the heart muscle and valves. The children of well-to-do persons are better protected against the ravages of rheumatism for they have home surroundings in which they can live, grow up and be educated under conditions which arc comparable to those which exist. in a special convalescent home. The prognosis is more favorable in these children because the disease is likely to be recognized in its early stages and suitable treatment given at a time when it is possible to prcvcut the development of progressive changes leading to :I serious cardiac disability. Slater,
Solomon
matic Fever.
IL: Am.
The Involvement J. hf. SC. 181:
203,
of the 1031.
Coronary
Arteries
Three cases of adults with acute rheumatic fever are cited electrocardiographic evidence of coronary arterial involvement. acute coronary closure was also suggested strongly by the pericardial friction rub, leurocytosis and fercr. It seemed none of tire brunt the endocardium received practically rheumatic virus. All three patients recovered.
in
Acute
Rheu-
in detail which showed The diagnosis of symptoms of collapse, that in all three cases of the attack of the
rheumatic infection any blood vessel, It is emphasized that during an acute large or small may possibly be involved and that those of the heart may likewise be involved; that when the larger coronary branches are affected under certain circumstances it may be suflicient to encroach so upon the lumen as to occlude it.; or a thrombus may occur secondarily producing a closure. When the closure cmurs, the patients experience cscruCiating pains indieativc of the lesion.