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Minor Cardiac Affections.

New Growths.—While new growths may originate in the myocardium or endocardium, they are more apt to be an extension from the parts. Cancer, as a primary disease of the heart, is of very rare occurrence, though as an extension from the mediastinum, the lungs, or pleura, it is occasionally seen.

Syphilitic deposits are found on the valves, and in the ventricles, more frequently the left. Cysts are very rarely found. Myxomatous, fibroid, lipomatous, sarcomatous, lymphoid, and sometimes chondromatous growths occur, though they are not common. They are more apt to develop in the pericardium than in the heart substance.

The symptoms are negative, and the growths are only discovered post-mortem; hence the prognosis and treatment need no consideration.

Parasites.—The heart may be the habitat of four forms of parasites; the taenia echinococcus, cysticercus cellulosse, actinomyces, and pentastomum denticulatum. The first two, by developing cysts, may produce serious results. They are more frequently found in the right ventricle. When they rupture, if it be in the right ventricle, secondary cysts of lung sometimes develop. As a result of rupture of the cysts, portions may float off in the general circulation, and give rise to embolic abscesses in various organs of the body. These cysts are generally found in the liver and other organs at the same time.

Misplacement.—Malpositions of the heart may be congenital or acquired as the result of excessive tympany, ascites, tumors, or disease of neighboring parts. The most important and remarkable congenital malposition is where the heart is located to the right, in place of the left median line. The apex-beat is found in the fifth interspace of the right side, and the general boundaries are the same, otherwise, as if located on the corresponding side. The arch of the aorta curves over the right bronchus instead of the left, and the descending aorta is to the right of the spinal column instead of to the left. Usually there is an interchange of the other organs, though not always. Thus the liver takes the left side, and the spleen occupies the right.

In the fetus the heart occupies the median line, and occasionally this persists after birth. Another malposition is where the heart is found immediately beneath the skin, the sternum being missing. The heart has also been found misplaced in the abdominal cavity.

A rare and a serious displacement is where the heart occupies the cervical region. Floating heart is that condition where its attachments become weakened and relaxed and the heart becomes more or less motile.

Wounds and Foreign Bodies.—Although wounds of the heart are generally fatal, occasionally an injury of the heart occurs that startles the medical world. Bullets have been found encysted in the ventricles, and only recently a man was stabbed in the heart, severe hemorrhages followed, but the surgeon hurriedly opened the pericardium, stitched up the gaping wound, and, to the surprise of every one, the patient recovered. Pins have been found imbedded in the heart.

The Eclectic Practice of Medicine, 1907, was written by Rolla L. Thomas, M. S., M. D.

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