The aneurysmatic swelling---not yet very large comparatively-----cambers visibly forward the region of the manubrium sterni along with the incisura and fossa jugularis. The sternal extensions of the musc. sternocleidomastoid., specifically those of the right, are likewise heaved up. The entire region shows a pronounced heavy pulsation. The heart is dislocated out and down, left ventricle somewhat hypertrophic. Profuse arteriosclerosis. Pulsus differens. Right radial pulse nearly impalpable.
52 year old, from a family free of illness. No syphilis, contrariwise potator strenuus.
First appearance of the malady about 8 months prior: loss of breath, pains when stooping. Later throes behind the sternum, which streamed out to the left arm, angina pectoral like attack.