Pulmonary There was a appearance was Invariably panding of time to if be acute and lesions heart, certain the made and it are may diagnosis occasionally proves pulmonary and The only by by the with matic may existence cyanosis hernia, simulate addition duced tions aorta, lesions degenerative neoplasms these lesions customarily which are abnormal defects, or of the usually employed present in the unreliable. observation When of the considerable aid. the directly vascular affect ring shunts. It have congenital air cyst, lung and symptoms is significant the trachea anomalies.1 Other clubbing, of blood that not all etc., caused infants heart disease. A large dlaphraganomaly, or pulmonary hemorrhage of congenital heart disease. In lesions. Aortlc Arch: congenital connection to arteriosus upper lobe recurrent anomaly the right may infections retraction sometimes pulmonary or llgamentum bronchus may the pulmonary Pulmonary Head and offer treatment cardiac primary may other and to Insufficient pulmonary blood flow and congestive failure inby some congenital lesions, superimposed subacute bacterial infecmay result in embolic infarction, multiple abscesses, and patchy Right This carefully accurate, of Fallot, produce dyspnea, cyanosis, due to lack of proper oxygenation or dyspnea congenital the signs pneumonIa A. of Our the diseases rapidly ex- Lesions compression defects, such as tetralogy but these symptoms are heart aorta, signs heart consider be when many be found wanting difficult the detailed vascular direct clinicians congenital Although the criteria pleural congenital bronchi to the and Congenital or to certain of arteries pulmonale. features, living course of or “pleurisy”. are inflammations each of essential these Diseases* York the prognosis cor Heart F.C.C.P.t memory signs during as “pneumonia” coronary and chronic distinguishing cardiac, New Among the diagnosis of the differential Brooklyn, within diagnosis chronic of M.D., has effective. of N. E. REICH, pulmonary described knowledge possibilities is Complications artery arteriosus produce and through (Figure atelectasis, (tracheobronchltis artery symptoms form or to compress the include dyspnea, stridor may *presented at the Clinical Meeting, New Chest PhysIcians, February 19, 1953. tClinical Assistant Professor, Department York, College of Medicine. in York Downloaded From: http://journal.publications.chestnet.org/ on 06/09/2014 pneumonia). It surface cough, infants. State ring a short These Chapter, of Medicine, 649 vascular 1). Pressure obstructive anterior cyanosis, occur a State by patent its ductus on the emphysema, right may cause of and or also the trachea. chest pain. symptoms American University may College of of New 650 N. E. REICH be initiated later in life owing to posterior X-ray displacement studies of the level of position the third delineate intervertebral anterior tracheal Angiocardiography vascular When divided, B. Double This left Aortic anomaly encroachment x-ray changes relief is portion C. some upon similar the to degree, artery to and compression the the fall elongation at studies in just above reveals both fourth small (Figure trachea those the double Pulmonary exact the the location llgamentum forward.3 the lateral carina. of the arteriosus Is and listed branchial 1). esophagus, under the ligation and arteries The persist. vascular ring The produces resulting In symptoms and right aortic arch. Complete extirpation of to with the left (anterior) arch. Stenosis: Pulmonary in Is usually by the when arch afforded of film) by 1954 Arch: occurs (anterior) caused aorta. reveal space.2 Lipiodol compression second is of marked pulmonary the traction of the arteriosclerotic barium-filled esophagus (seven deformity. obstruction allowing June, tuberculosis congenital has heart stenosis and tetralogy of cent. Superimposed subacute lesion with pulmonary tion, pneumonitis, The Blalock shunt or been CRTIC This embolization lung abscess. operation has may also been PIN(5 .-. . 4 1 FIGURE Downloaded From: http://journal.publications.chestnet.org/ on 06/09/2014 This 1 AORTIC frequency of pulmonary incidence congenital results success, ANOMALIES LA. - the with DOUBLt . greater true an on occur. employed ACW - occur is especially Fallot. Abbott4 found bacterial infection VASCULAP rnegr found conditions. ARCH but of 36 per cardiac in inf arca direct Vol. PULMONARY XXV attack producing D. on the stenosing tissue equally satisfactory Patent Ductus Ordinarily, pulmonary gestion may occur the pressure this latter results or use of of antibiotics irregularly course of studies (Figure of acute may use the of embolic are is presently a return flow Pulmonary size. and may now of producing the conmost bacterial the ensue. to The subacute infarctions Rheumatic lung. Ligation Mulof remarkable the cures. Fever Part extend migratory not rheumatic 2). ACTH rheumatic from 2 to to or areas fever.5 one all the cortisone of FIGURE 2A lobes. although the of may The this been reported diagnosis is at the changes hemorrhagic features. pulmonary This lobe has the usually occurs pathologic The prominent and migratory of nature pneumonia 15 per cent, involvement fever. scattered and sputum are signs of transitory the 651 operation failure pneumonia Pneumonic acute rheumatic Cough finding process punch cases. Is of considerable heart in patchy Incidence of as varying overlooked. attack of essentially DISEASE Pneumonia: Although the careful observers quently of an HEART aorta allows communication. shunt congestive Acute A, Rheumatic or other in the abnormal if the are abscesses and by incision results in eventually The small ductus higher through complications endocarditis. tiple OF Arteriosus: the artery frequent COMPLICATIONS demonstrable be involved lesions diagnosis exudates rests during on or the clear Is difficult height consist consolidation. The is by fre- serial x-ray inflammatory rapidly to on the evaluate following because lesions. FIGURE 2B Figure 2: Rheumatic Pneumonia. (A) Irregularly scattered areas of soft infiltrations throughout both lower lung fields, more marked on the left side. Onset of pneumonic involvement occurred the previous day.-(B) Marked diminution in extent and intensity of the infiltrations the following day Illustrating the transitory nature of the exudates. Downloaded From: http://journal.publications.chestnet.org/ on 06/09/2014 652 N. E. REICH Virus pneumonia matic fever platelike transitory, B. may of the Rheumatic acute low atelectasis demonstration is probably inflammation or follow severe another of the as effusion In a cloudy high percentage serofibrinous acute may pericardial pain and presence adhesions of which partially Chronic Mitral valvular occurrence of congestive heart and lesions, cardiac the with and pulmonary in and fluid A clear hemorrhagic, Although may the be a scalloped in any or fluid pleuro- appear- advanced blood lost present, streaked degree is firm, for the a result dense, They interferes and also with symptoms. cent during of usually As of early chronic red-brown in increased collagen, and thickening These changes thicken the alveolar major 10 per time account cases. become which are denotes Cough is commonly but may be blood There only the several demonstrate required. appear may many exchange. tissue usually an Characteristically, disappear within silhouette stenosis, lungs orthopnea The in found sides Disease in oxygen lung Hemoptysis occurs it may appear at congestion. fever Although space. Valvular congestion failure, the on is seldom it may but pleural especially pulmonary of Dyspnea of with but produce and when productive, or frankly purulent due may mitral of also be stenosis. the disease, increasing indicates an expansion. Cyanosis cases of the course stenosis small may lung Alit pulmonary a dire prognosis. the sputum to secondary is mucoid, broncho- infection. Acute Pulmonary Acute pulmonary lesions exertion, even an tachycardia. talization, are not blood. they are or both roentgenograms the the evident. though heart which in the Failure: interfere inelasticity B. rheucough, clinically fever, either involvement.5 friction rub appearance. There is interstitial edema, of the capillary basement membrane. wall other hacking rheumatic tissue. recognized pulmonary infarction. develop occasionally. give obliterate Congestive is Aspiration occurs Mitral A. of of of acute connective rheumatic occur Routine of cases. exudate adhesions or absence from the hilium hemagglutinins pleuritis accumulates. due to the absorbed, perlcardial ance cold the persistence manifestation subendothelial serofibrinous lung or inspiratory days possibly is rapidly count, radiating of 15 per cent of all cases of the cases at autopsy. They usually initial by white 1954 Pleurisy: fibrinous 5 to half differentiated manifestations, areas and Pleurisy owing to be June, in edema when regular operation, Attacks the Edema: presence morphine are may precipitated of pulmonary and atropine, Downloaded From: http://journal.publications.chestnet.org/ on 06/09/2014 occur sinus pregnancy, in mitral rhythm rapid by the congestion. oxygen, stenosis and exists. It usually digitalization, added valvular follows severe or paroxysmal strain on Treatment mercurials other the includes and antifoamlng right digi- Vol. PULMONARY XXV agents.6 Subsequently, have already been C. COMPLICATIONS valvuloplasty reported by OF may be surgeons. many DISEASE HEART indicated. 653 Remarkable results Rupture: Rupture of pulmonary bacterial D. a The pulmonary this from to coronary of that clots the right overlook or success for discussed result during auricular major of the with and causes to Septal may visualized on be in most adequate cases The when pleura but is is or other the use Ampu- employed infections right of heart with the stenosis, combined congenital congestion, Pleural in pulmonary Symptoms may be be ductus lesions usually effusions or arterial include present. selected obviously patent may bronchopneumonia, Infarctions film. valvular However, cases. In all must tricuspid The properly clinical and finally, progressive sion may result fluid is Nonspecific commonly frequently involved overlooked. Cases are now from two to laboratory accompanied or followed either or both sides which to a pleural effusion of rated venous condition and and mortality. many microorganisms. for 95 per cent of the focus. infarctions, x-ray Important pelvic and too small hemorrhages branches cough, Antibiotics when or are may chest are are result pain, effec- administered in dosage. is emphasized.7 rences has ranged the by lungs or Acute origin bacterial encountered. the is of (Madden). caused accounts not uncommonly found. Emboli in arteritis or mycotic aneurysm. and dyspnea. Bloody expectoration tive of be Fallot, It or presently it discharge Endocarditis the the necessary emboli and is Suffice the peripheral appendage pulmonary of as embolizatlon forms defects, abscesses be in subacute fibrillation. such auricular reach tetralogy also provide Pulmonary to results elsewhere. from the primary heart reduced morbidity recurrent subacute emboli arteriosus, lung rapidly superimposed trauma. are treatment of have greatly cases acute affected. or may mural endocardium may nonhemolytic streptococcus order by complication auricle other ligation in The tendlnae caused thrombosis, Bacterial and the chordae be infarction serious thrombosis. Early of anticoagulants tation or may Infarction: effects say not muscle This endocarditis, Pulmonary to papillary congestion. in pleural extensive exudative Downloaded From: http://journal.publications.chestnet.org/ on 06/09/2014 acute of by the last for degree nonbloody, pericarditis recurrent on record 19. A pleural thickening. compression and in The findings shortly may varying Pericarditis in nature which lesion acute the must nonspecific of of nonspecific this number of be suspected disease recurwhen pericarditis are onset of a pleural friction rub on days or weeks. This may progress (usually small in amount) and, Large amounts atelectasis and may of pericardlal (FIgure 3). The be bilateral.8 effuaspiPleural 654 N. E. REICH fluid is improvement the demonstrable of the presence by roentgenogram. pericarditis and of pleural The condition is secondary pericarditis absence of mycetin and lung findings on x-ray have constrictive which normal case tuberculosis clinical The ever, of pleural the do adhesions not or reveal Dyspnea effusions congestion, or vein orifices be decreased never are may aureomycin, cause been significant scar Is localized chamber may be with and chloro- far. thickening and which by a small in cent pericarditis. has pneumonia leucocytosls fibrous the heart clinically 15 per tuberculosis constrictive pulmonary engorgement.8 and ascites. commonest disease) following suggest Pericarditis for only pulmonary chronic entity. lungs usually around monary accounts inactive (Concato’s stricting pericardial and filling of this with thus 1954 is uncommon. atypical cough, Results equivocal Constrictive pressure is the this disease of active or occasional film. been fever, further involvement primary of initial pericarditis is a dense may cause compression of filling. It is characterized heart, elevated venous Although tuberculosis etiology, evidence Pulmonary from absence Chronic Chronic pericardium feres with Persistence of invariable recovery involvement. differentiated by the terramycin June, cases of may fairly may to vital capacity Thus, In an in extensive a When marked to to distinct fibrosis. auricle, with. pleural owing due be or common. result to proved cases. found Polyserositis over the left interfered due with all be proved congestion mainly seriously of the interquiet Howthe con- relaxation Constriction pulmonary effusions, marked pulelevation A FIGURE 3A FIGURE Figure 3: Massive Pericardial Effusion producing extensive tissue. (A) PA view shows marked water bottle appearance.-(B) of LAO view shows extent of fluid posteriorly with contrast and aorta. Downloaded From: http://journal.publications.chestnet.org/ on 06/09/2014 3B compression of lung Anglocardlogram media in left heart Vol. PULMONARY XXV of the diaphragm cent of normal Dramatic stricting are of In COMPLICATIONS by ascites. the cases improvement scar tissue. value in the OF HEART The vital capacity reviewed by Stewart occurs Streptomycin, treatment following DISEASE was reduced up and Heuer.#{176} surgical removal to of PAS, and Isonicotinic active tuberculous lesions. of 655 acid 68 per the con- derivatives Syphilis aneurysms may symptoms Saccular and of structures depending (Figure 4). greater proximity tasis, may be the bronchiectasis, elicited and 4: Effect alarming direction the arch and secondary left recurrent Phrenic thereby interfering of cardiovascular Downloaded From: http://journal.publications.chestnet.org/ on 06/09/2014 proportions and the lungs, bronchi, and extent of of the respiratory or aphonia. diaphragm, FIGURE of to reach compression on Aneurysms in hoarseness of signs are most structures. infection laryngeal nerve syphilis their because signs may result. compression may other dilatation important nerve produce and Pulmonary involvement with may of of Tracheal may produce the respiratory tug result paralysis oxygenation. on their atelec- system. 656 N. E. REICH The lesion most Important is sufficiently sign because to localize 100 cc. of of these complications extensive, tactile fremitus the failure properly wall breath sounds and may bronchial or elicit altered ensue area or of chial tumor is unreliable expansile tion of tissue sputum on pulsations adenoma, rarely for agulated, shrink bronchial when carcinoma, tree. the or have to the Diminished be noted. infection myocardial findings Bron- induced tests biopsy, are by pulmonary exclude endobron- The Further differentiaor granulomatous of the ascending cases of luetic position have been aorta aortitis. In wired the 300) (LAO treatment and (PT rupture. of 85 electrocoin order to Infarction complications following mass. This show typical is following this possible lesions In must patients be suffering considered when condition. Edema: pulmonary ventricle dominant complication Is most commonly manifestation within Symptoms hours or especially on noisy respirations advanced cases atropine, the up is the appearance pour out of to the apices. diuretics, treatment dyspnea, orthopnea. be Edema of the copious oronasal Digitalis Downloaded From: http://journal.publications.chestnet.org/ on 06/09/2014 acute pulmonary more white or passages preparations, and antifoaming edema.6 may episodes and dominant rales are become Cough by respirations may appearing occlusion. characterized wheezing failure, It may infarction artery anticoagulants, of ventricular infarction. by myocardial common when the heart failure. Basal side. acute a coronary may with right and it may audible in the acute oppression, attack dyspnea congestion congestive Is due to affected following The nocturnal Mild pulmonary is pain, shock, days thoracic feature. paraxysmal of an to include a prominent and occasobstructions or Papanicolaou staining positive in approximately established Aneurysms infarction. This serious since the left are differentiated localized may by Polythene Cellophane further expansion with appear Pulmonary suddenly be of Tomography a definitely surrounded or prevent of lung be the must cause in the wall half of all syphilis. them from employed hands ordinary lightly may and aneurysm is unclotted. and inspissated mucous Calcification approximately now A number phine applied percussion drainage Myocardlal rales the An satisfactorily.’0 lesions the true requires bronchoscopy, tumor cells. Serologic cardiovascular cases, bulb of ones. by delineating cavitation within the anetirysmal when the aneurysm is clotted. Kymography may Antibiotics be Unless the a misleading sense early more of and other may reveal the per cent of cases. view) is found In A. tactile electric resonance lack of extensive changes from is atelectasis. is frequently 1954 compression. distortions of wide 75-watt minor Endobronchial tumors ionally. Bronchography or a lesions flask may chiectasis of small Erlenmeyer chest June, of rhonci. manifestation heard In such severe with pink and foam. In bubbling oxygen, agents morare PULMONARY Vol. XXV B. Atelectasis: It at is very the left like areas of atelectasis. C. of usually be of cases dullness and indicates value in following patch x-ray this is found Pneumonia this is 657 breathing crepitant frequently early not necessarily infection.1’ without rales, plate- of in temperature Oxygen obviously the indicative eleva- and expectorants contraindicated in infarction. The D. is associated Is made possibility infarction, leucocytosis, signs, rarely diagnosis as such. pulmonary hyperpyrexia, Localized This complication usually bilateral. clinical and patients. is usually x-ray Pulmonary When severe of film is in acute commonly with gross is require dullness addition to lung myocardial confused dullness rales frank Infarction and with pneumonia or flatness is frequently hemoptysis, congestive and bronchial heard. The marked failure may lung thrombosis infarction. may pyrexia, ensue in some diagnostic.” and cases but are usually present, recurrent in edema, there is is indicated. the the pulmonary artery branches, but base. The sudden onset of chest usually heralds this complication. rales, the treated Infarction: any part of to the right expectoration in half Effusions and patient pulmonary When sputum, antibiotic It is well to remember that emboli to auricular fibrillation and peripheral venous sided mural thrombosis due to myocardial crepitant the such as localized must be investigated. In addition to fine inspiratory of Signs The an infarction and Edema: infarction. shower course myocardial frequency mucopurulent with is not uncommon The condition leucocytosis. acute alarming and trial Pulmonary a with with of other lesions or atelectasis a therapeutic or pulmonary breathing, or in so and or the presence of atelectasis. therapy. Rebreathing is myocardial DISEASE or patches of film demonstration by Wolff infarction, bronchial HEART Pneumonia: yet E. However, it is considered normal failure, pulmonary area tion may OF common to find a localized lung base, coinciding with attack that of congestive An COMPLICATIONS fluid effuslons aspiration. a rub too bronchial is diagnosed small in may be may dominate The clear icterus Downloaded From: http://journal.publications.chestnet.org/ on 06/09/2014 breathing. in amount may commonly proceed cough and bloody include localized Pleural pain 10 per cent of to be recognized clinical is cases, only sanguinous. the index third day. The electrocardiogram a large percentage of the disappointing. Immediate ligation must be considered pelvic veins is suspected. or most pain, Signs occur following as well as rightEmboli may enter be slightly diagnostic but x-ray anticoagulant therapy when embolization On rarer but elevated (acute investigation they on cor present cases.’2 clinically. occasions, picture, is from Is the the large seldom second pulmonale) is usually Indicated. Venous the peripheral or 658 N. E. REICH Dissecting There has been aneurysms awareness the of to and dromes rupture. a single factor per Twenty cavity pleural the cent of all nificant indicate Blood replacement availability it possible of to and site of rupture may by applying Polythene be left of of into into the right described directly into by (PT the left alone), and pleural on rare pleural left due malignancy is highly sigbacilli space, mediastinum occasions. Massive bronchi or indicated. The and Streptokinase) aspiration. Surgical now repair employing 300). or tubercle trachea, are syn- dissection fluid cells aspiration (Tryptar prior to attempted Cellophane side the factor.’ include Fluid in the from that bloody malignant although clinical extent an limiting pathologic but signs rupture the to at various and Aspirated due unsuccessful fatal, affects dissecting been Efforts important of rupture aneurysms been agents clots clinicians. site of has signs of chest fluid.’3 must be differentiated pleural enzymatic liquify blood recognition This generally the presence rupture most instantly on Ruptures have the 5). most absence syndrome. The be investigated. other structures may not seldom Meig’s dissection. hemoptysis been dissecting (which and for have characteristic to such ruptures failure pleura, of depending and present cavity due to circulatory part as the in the When appear in (Figure the recognized are rare hemoptysis. may decade on 1954 Aneurysm improvement last disease necrosis is symptoms cough must and the the pathology medial Pulmonary of a marked during June, gelatin sponge lung. recent makes of the cuffs or Neoplasms Primary concerned mately of types and secondary presently only once in has every been tumors with 2,000 of the primary cases reported in that the heart are neoplasms. come to following relatively They rare. occur autopsy.14 order: The myxoma, We are approxifrequency sarcoma. I,_____ ,a2.. WAil CF ACF?A l#{232}-A* FIGURE Figure massive 5: Dissecting hemothorax. 5A Aneurysm. Eventual (A) Roentgenogram Downloaded From: http://journal.publications.chestnet.org/ on 06/09/2014 FIGURE rupture into the prior to rupture.-(B) 5B left pleural Injected space with specimen. PULMONARY XXV Vol. COMPLICATIONS rhabdomyoma, fibroma, and epithelloma. eplcardlal plasm, but metastases of of may red produce valvular lesions lesions. with or of of subsequent pleural cells or may tumors although life be effective been when Chronic and chemotherapy may be cor prolonged In is or without Since primary heart However, it pulmonary process we (e.g., Systemic are of pleural the transudates secretions reveal is benign tumor pedunculated. (Beck, produced no known cures cases of applied malignant to Bailey). thus far, lymphoma. hypertrophy failure. the when on and other valvular vascular circuit not failure the disturbances, Is the basic be of considered. supervenes, underlying other lung bronchopulmonary lesions, right etiology complications will congestive the a varied pulmonary factors superimposed of Despite cardiac and the pulmonary with rheumatic and heart heart emphysema and that secondary The diagnosis the pulmonary suggest the pulmonary that pulmonary hypertrophy enlargement simulate disease diseases). and other causes of failure may eventually result in pulmonary hypertension. Concardiac lesions with an arteriovenous shunt (patent ductus septal defects, aberrant pulmonary veins) may be at fault. of an aortic aneurysm into the pulmonary artery or rupture of of opinion kyphoscoliosis. or metastatic further when an aneurysm of the right sinus of Valsalva may Various diseases of the pulmonary arteries may collosis, funnel chest, and other chest deformities in tumors and Pulmonale term dealing become hypertension, left-sided genital arteriosus, Rupture a the significant findings Cor of pulmonary, pressure in disease, is aspira- within some congestive which includes a number increased resistance and mechanism.7 heart an unelectro- pericardial orifices of should tumor from have pulmonale with valve neo- of shows progressive (3) bronchial the removed Chronic ventricle, cases Intracardiac true stained of pulmonary found. origin. have Radiotherapy and Is especially when in Pedunculated of site Therefore, frequently roentgenogram there are appearance involvement This non-carcinomatous Treatment Such cells. obstruction The without tumor (1) (2) teratoma, the suspected unexplained, tumor malignancy. contain cells and intermittent possibility also otherwise cells be are be when shape, may involved. should etiology size or heart changes reveals lesion papilloma, chamber commonly malignancies 659 DISEASE HEART cystoma, heart Is more cardiac primary undetermined or bizarre cardiographic tion a angioma, Any the right side from primary Diagnosis disease expected lipoma, OF dilatation of the syndrome These deformities emphysema of chronic underlying in causative with recognizable by venous pressure, or the and the occurs right in may produce a similar also be involved. may similarly ventricle. addition to cor pulmonale bronchopulmonary is based factor the without presence prolonged Downloaded From: http://journal.publications.chestnet.org/ on 06/09/2014 and evidence of It Is the about 75 per cent of cases also produce compression hepatomegaly, arm to lung of discovery failure. right Right-sided dependent circulation time. consensus of severe atelectasis Infections. the recognition upon of effect. Kyphosresult ventricular failure edema, elevated It is important is 660 N. E. REICH to remember lung or heart that dyspnea disease, but and may cyanosis be June, are aggravated usually in due the to presence the 1954 underlying of congestive failure. Roentgenologic due (b) to enlargement enlargement studies of of the show the right (a) an pulmonary ventricular exaggeration artery outflow of and the its tract hilar markings major in the branches, LAO view -I 0 -J <0 U I 0 -J 6: Chronic Cor Pulmonale. Electrocardiogram and roentgenogram of PA view showing pulmonary hypertension (prominent pulmonary segment and enlarged right auricle) secondary to extensive pulmonary tuberculosis. Diagrams of cardiac outlines in the standard views. FIGURE Downloaded From: http://journal.publications.chestnet.org/ on 06/09/2014 PULMONARY Vol. XXV as indicated and tricle in by the in the may become inflow tract increased in fluid PA (Figure as patent 6). When must be high underlying at trial. and or the surgical failure results type Antibiotics since it In oxygen of are right ventricular many disorders, others, such may result therapy failure but in as com- is indicated. should be beneficial in the presence indicated in the presence infections. depresses auricle ventricular is further changes or right In prove right venpulmonary the progressive bronchopulmonary contraindicated (a) groove, the the of the right of the heart congestive intervention may volumes. intercurrent of of lesion. develops, in this 661 Interventricular unsatisfactory. Venesection cell a causative usually early frank heart equivocal plasma definitely the DISEASE occurs, show is arteriosus, a therapeutic of of decompensation directed it plete relief. When Digitalis produces of HEART by the encroachment and (C) prominence Electrocardiograms kyphoscoliosis, ductus given displacement position space, view. OF enlarged, (b) there is enlargement as well, (c) the transverse diameter size, (d) the lower lung fields reveal strain pattern. Treatment such posterior right lateral the retrosternal on segment the COMPLICATIONS Morphine respiratory activity. during proper the course diagnosis, is SUMMARY 1) heart and 2) The appearance diseases must therapy. Pulmonary cardiac complications defects, degenerative plasms of acute of and 3) Cardiovascular marked hypertrophy hypersecretion 4) The venous, and arteries pulmonale. the and aorta, system to edema, bronchospasm to various infections. diagnosis, and cardiovascular and disease therapy been la evoluciOn neo- compression, to hemophypertension, disease and have aorta, primary or bronchial veins leading or combined ef fusions. Heart to congenital heart arterial, pleural and of many prognosis certain of cause tracheal arteries and differential due following and mucus, disorders appear pulmonic infarcts, respiratory of for inflammations the coronary chronic cor pathogenesis, piratory chronic disease may of bronchial tysis, pulmonic pulmonary emboli the lesions carefully may and lesions heart the disposes of pulmonary evaluated be pre- bronchial of these res- presented. RESUMEN 1) La apariciOn afecciones diagnOstico 2) Pueden ciones cardiacas 3) La bronquial, pueden monares lesiones lesiones del enfermedad marcada provocar o de ambas, pulmonares durante de debe ser corisiderada con cuidado para asi como pronOstico y su terapeutica. complicaciones pulmonares en ciertas congenitas, y de la aorta, plasias primarias que de del corazOn, adecuado aparecer infiamaciones degenerativas corazOn y en cardiovascular hipertrofia hemoptisis, embolia Downloaded From: http://journal.publications.chestnet.org/ on 06/09/2014 de agudas y crOnicas de las coronarias el cor pulmonale las puede causar compresiOn arterias bronquiales hipertensiOn pulmonar. y de crOnico. de El las padecimiento venas muchas hacer un malformadel la y de aorta, corazOn neo- traqueal y las venas y arterias pul- pulmonar pre- 662 N. E. REICH dispone mucosa el aparato asi como respiratorio al a varias infecciones. 4) Se presentan consideraclones renclal y el tratamlento de enfermedad cardiovascular. June, edema, broncoespasmo sobre la trastornos estos 1954 e hipersecrecion patogenia, el respiratorios diagnOstico debidos dif ea la RESUME 1) Li est n#{233}cessaire pulmonaires Ce au n’est qu’ainsi pronostic 2) On certaines aigues Les divers, ou t#{232}mes a la cause chique 4) ment en des du coeur et de l’aorte, affections infarctus et cardiaques expose atteintes outre a l’oed#{232}me, au aux infections la nombreuses pathogenie, respiratoires des de l’aorte, dans lesions lesions du bronchique, coeur #{234}trela pour l’appareil diagnostic cons#{233}cutives a cas cause de des ou des pulmonaire troubles art#{232}res et d’hemoptysies, des deux epanchements bronchospasme, diverses. les digeneratives hypertrophie pulmonaires, le in! lamma- et coeur entralner l’apparition art#{233}riel ou veineux le diagnostic, pulmonaires primitif sont, cardlaques. le congenitales, ou alterations affections peuvent ou embolies en caracteres complications cardio-vasculaires trach#{233}ale pr#{233}disposante de mucus et L’auteur de ces de les #{233}tabllr correctement cancer poumonaires, pouvant du syst#{232}me pulmonaire fois, soin cardiaques chroniques affections avec l’#{233}volution pourra anomalies compression des vaines hypertension Les de qu’on art#{232}res coronaires chronique. 3) cours et le traltement. peut voir apparaitre suivants: toires d’#{233}valuer respiratolre, une l’hypersecretion diff#{233}rentiel, et aux affections sys- pleuraux. bronle traitecardio- vasculaires. REFERENCES 1 Reich, N. E.: “Diseases of the Aorta,” C. C. Thomas, Springfield, Ill., 1949. 2 Neuhauser, E. B. D.: “Roentgen Diagnosis of Double Aortic Arch and Other Anomalies of the Great Vessels,” Am. J. Roentgenol., 56:1, 1946. 3 Gross, R. E.: “Surgical Treatment for Abnormalities of the Heait and Great Vessels,” C. C. Thomas, Springfield, Ill., 1947. 4 Abbott, M. E.: “Atlas of Congenital Cardiac Disease,” Am. Heart Assn., N. Y., 1936. 5 Reich, N. E.: “Protean Manifestations of Acute Rheumatic Fever,” Am. PractItioner, 12:645, 1947; “Acute Rheumatic Fever in Uncommon Sites,” Am. Practitioner, 2:328, 1951. 6 Reich, N. E.: “The Use of 2-Ethlyhexanol in Acute Pulmonary Edema,” Dis. of Chest, 23:43, 1953; “A New Therapy for Acute Pulmonary Edema,” N. Y. State J. Med., 52:2647, 1952. 7 Tomlln, C. E., et al.: “Recurrent Nature of Acute Benign Pericarditis,” J.A.M.A., 149:1215, 1952. 8 Reich, N. E.: “The Uncommon Heart Disease,” C. C. Thomas, Springfield, Ill. (In press). 9 Stewart, H. J. and Heuer, G. J.: “Chronic Constrictive Pericarditis: Dynamics of Circulation and Results of Surgical Treatment,” Arch. mt. Med., 63:504, 1939. 10 Reich, N. E.: “Method of Applying Flask to Chest In Tactile Fremitus,” N. Y. State J. Med., 39:1654, 1939. 11 Wolff, L.: “Diagnostic Implications of Pericardial, Pleural and Pulmonary Involvement in Cardiovascular Disease,” N. Eng. J. Med., 244:965, 1951. 12 Sagall, E. L., et al.: “Clinical Syndrome In Patients with Pulmonary Embolism,” Arch. Int. Med., 76:234, 1945. 13 Reich, N. E.: “Dissecting Aneurysm of the Aorta: A Clinicopathologic Correlation of 19 Cases,” Clinics, 3:346, 1944. 14 Lymburner, R. M.: “Tumors of the Heart: Histopathological and Clinical Study,” Canad. M. A. J., 30:368, 1934. Downloaded From: http://journal.publications.chestnet.org/ on 06/09/2014