Plate 47

Plate 47

Aneurysma arcus aortae sanatum?

In all probability one of the most exceptionally rare cases of a healing, i.e. cessation of an aneurysma arcus aortae.

75 year old, previously a completely healthy mason. Neither luetic nor alcoholic. Suffered for a long time from chron. bronchitis with a lesser emphysema. Heart palpitations during the last year and a far more manifest cardiacal asthma from respiratory complaints corresponding to the bronchitis. Simultaneously with this the formation and slow growth of a proptosis in the upper segments of the chest bones. Admitted into the clinic because of the mentioned heart troubles and severe edema of the foot right up to the middle of the calves.

The plate shows the region of the manubrium sterni severely pushed forward, quite a bit stronger in the upper than in the lower end. Thus, the base of the sternocleidomastoideus is shunted far forward (as the photograph shows especially well) and the bore of the throat is greatly enlarged front to back. Regarding the protruding parts of the sternum, severe attenuation but no pulsation. However such is the case even in the fossa jugularis, when deterioration is perceptible. Heart tone pure, rather loud. Massive hypertrophy of the left ventricle. Diffuse arteriosclerosis. Aneurysmatic development of the carotis externa dextr.

Patient was not clinically observed at the beginning of his ailment. Pulsation over the sternal proptosis absent, even, at the first recording. But its development and its constant growth along with a corresponding rise in heart complaints, the extant arteriosclerosis and the aneurysm of the carotid puts the supposition nigh, that this is for the most part an aneurysmatic sack filled by an embolism. (viz. also Curschmann regarding improvement and healing process with the aneurysm of the chest aorta. Work from the Leipzig Med. Hospital. 1893. F.C.W. Vogel).

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