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NORTH CAROLINA MEDICAL JOURNAL February, 1942 Fig. 3. Roentgenogram of the chest in a case of coarctation of the aorta. Note the scalloping effect produced by erosion of the inferior margins of the ribs (Lewis, Thomas: Material Relating to Coarctation of the Aorta of the Adult Type, Heart, 16:205 (June) 1933). as the primary diagnosis, if the peripheral arteries are not examined and the collateral circulation over the chest is not discovered. Anomalies of the other great vessels arising from the arch of the aorta are more the rule than the exception in this condition and can sometimes produce bizarre phenomena. In one case which was called to my attention, the constriction of the aorta occurred above the origin of the left subclavian artery, thereby giving rise to a remarkably low blood pressure and an almost total absence of the radial and ulnar artery pulsations in the left arm. While the diagnosis of coarctation is essentially a clinical one, certain accessory roentgenographic signs are of value when present. They are as follows: (1) a bilateral erosion or scalloping of the inferior borders of the ribs, which is almost always present, (2) an absence of the prominent aortic knob, usually associated with hypertension, and (3) a dimpling of the descending aorta which is best seen in the left oblique position (fig. 3). It is not difficult to appreciate the fact that ribs may be readily eroded by the large, tortuous, pulsating intercostal arteries, such as those observed in figure 4. Fig. 4. Sternal plate from a case of coarctation of the aorta. Note the extreme tortuosity and dilatation of the intercostal arteries, which have produced erosion of the ribs (Love, W. S., and Holms, J. H.: Coarctation of the Aorta With Associated Stenosis of the Right Subclaxian Artery, Am. Heart J. 17:630 (May) 1939). The frequency with which cardiovascular j anomalies such as the bicuspid aortic valve, I anomalous origin of the arteries from the I aortic arch, and congenital cerebral aneurysm are associated with coarctation would appear to be a significant part of the picture. J Of these associated anomalies, the small con-1 genital cerebral aneurysm is a source of such : potential danger that a further word is j necessary. The term aneurysm seems to be i a misnomer, for these pea-size dilatations I which occur at the bifurcations of the cere-1 bral arteries are so small that they are fre-B quently overlooked. They are not dependent■ upon infection or syphilis. Forbus(4) and I others in studying these cerebral aneurysms! have found a congenital absence of the medial of the arterial wall at the bifurcation of the| •t. Forbus, W. D.: On the Origin of Miliary Aneurysms ofH the Superficial Cerebral Arteries, Bull. Johns Hopkins*! Hosp. 47:280 (November) 1930.
Object Description
Rating | |
Fixed Title * | NCHH-17: North Carolina Medical Journal [1940-2001] |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1942 |
Identifier | NCHH-17-003 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 3 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-003.pdf |
Document Sort | all; nchh-17 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-003 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
Description
Fixed Title * | Page 68 (images) |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1942 |
Identifier | NCHH-17-003-0074 |
Form General | Periodicals |
Page Type | all; all images; x-ray; all images; photo; article |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | northcarolinamed31942medi_0074.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 3 |
Issue Number | 2 |
Page Number | 68 |
Health Discipline | Medicine |
Full Text | NORTH CAROLINA MEDICAL JOURNAL February, 1942 Fig. 3. Roentgenogram of the chest in a case of coarctation of the aorta. Note the scalloping effect produced by erosion of the inferior margins of the ribs (Lewis, Thomas: Material Relating to Coarctation of the Aorta of the Adult Type, Heart, 16:205 (June) 1933). as the primary diagnosis, if the peripheral arteries are not examined and the collateral circulation over the chest is not discovered. Anomalies of the other great vessels arising from the arch of the aorta are more the rule than the exception in this condition and can sometimes produce bizarre phenomena. In one case which was called to my attention, the constriction of the aorta occurred above the origin of the left subclavian artery, thereby giving rise to a remarkably low blood pressure and an almost total absence of the radial and ulnar artery pulsations in the left arm. While the diagnosis of coarctation is essentially a clinical one, certain accessory roentgenographic signs are of value when present. They are as follows: (1) a bilateral erosion or scalloping of the inferior borders of the ribs, which is almost always present, (2) an absence of the prominent aortic knob, usually associated with hypertension, and (3) a dimpling of the descending aorta which is best seen in the left oblique position (fig. 3). It is not difficult to appreciate the fact that ribs may be readily eroded by the large, tortuous, pulsating intercostal arteries, such as those observed in figure 4. Fig. 4. Sternal plate from a case of coarctation of the aorta. Note the extreme tortuosity and dilatation of the intercostal arteries, which have produced erosion of the ribs (Love, W. S., and Holms, J. H.: Coarctation of the Aorta With Associated Stenosis of the Right Subclaxian Artery, Am. Heart J. 17:630 (May) 1939). The frequency with which cardiovascular j anomalies such as the bicuspid aortic valve, I anomalous origin of the arteries from the I aortic arch, and congenital cerebral aneurysm are associated with coarctation would appear to be a significant part of the picture. J Of these associated anomalies, the small con-1 genital cerebral aneurysm is a source of such : potential danger that a further word is j necessary. The term aneurysm seems to be i a misnomer, for these pea-size dilatations I which occur at the bifurcations of the cere-1 bral arteries are so small that they are fre-B quently overlooked. They are not dependent■ upon infection or syphilis. Forbus(4) and I others in studying these cerebral aneurysms! have found a congenital absence of the medial of the arterial wall at the bifurcation of the| •t. Forbus, W. D.: On the Origin of Miliary Aneurysms ofH the Superficial Cerebral Arteries, Bull. Johns Hopkins*! Hosp. 47:280 (November) 1930. |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://hsl.lib.unc.edu/specialcollections/nchealthhistory/nchh-17-pdf |
Document Sort | all; nchh-17 |
Article Title | Coarctation Of The Aorta |
Article Author | T W Baker |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-003 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
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