A panel discussion on unsettled clinical questions in the management of cardiovascular disease was conducted at the Thirtieth Scientific Sessions of the American Heart Association held at the Sherman Hotel, Chicago, Friday afternoon, October 25, 1957. The panel was comprised of the following members: LOUIS N. KATZ,
Chicago, Ill.
, MODERATOR; GEORGE E. BURCH,
New Orleans, La.
; ALBERT DORFMAN,
Chicago, Ill.
; A. CARLTON ERNSTENE,
Cleveland, Ohio;
HANS H. HECHT,
Salt Lake City, Utah;
and ROBERT L. PARKER,
Rochester, Minn.
THE PURPOSE of this communication is to report the clinical and pathological features of a patient in whom a syphilitic aneurysm of the aorta ruptured into the pulmonary artery and to describe, in particular, the histopathological findings in the lungs related to this abnormality.The haemodynamic alteration of the circulation following rupture of an aortic aneurysm into the pulmonary artery is similar to that produced by a patent ductus arteriosus and an aortopulmonary septal defect of congenital origin. The physiological and clinical differences between the acquired and congenital cardioaortic fistulae are due to the sudden developmcnt of the communication in the former and the acute nature of the stresses imposed by the overloading of the circulation.
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