Studies on Epidemic Influenza: Comprising Clinical and Laboratory InvestigationsUniversity of Pittsburgh. School of Medicine
History
Studies on Epidemic Influenza: Comprising Clinical and Laboratory Investigations
University of Pittsburgh. School of Medicine
Influenza; Influenza Epidemic, 1918-1919
Abrahams, Hallows and French had an opportunity of observing over 400
autopsies upon the influenza patients, and they comment upon the
infrequency of cardiac dilatation. A slight dilatation of the right
ventricle was seen in a few cases, and in no instance did they find
pericarditis or endocarditis. They comment upon the heart condition as
follows: “The most remarkable feature about the heart is the general
absence of dilatation. In quite a large proportion of cases there has
been no trace of dilatation; in a fair number of others there has been
some dilatation of the right side, but this has seldom been extreme,
perhaps enough to cause the apex of the heart to be formed about equally
by right and left ventricles. Most often the heart has appeared of
normal dimensions and the apex has been formed entirely by the left
ventricle. This absence of dilatation accounts for the clinical absence
of orthopnœa.” In direct contradiction to the above findings, the
Advisory Board to the D. G. M. S., France, report the findings in 30
autopsies of clinical influenza. Twenty-nine of these 30 cases showed
dilatation of the heart, chiefly of the right side, but very commonly of
the left side as well. Twenty-one showed myocarditis and two
endocarditis. In this report it is stated that these patients showed
evidence of obsolete tuberculosis. It is possible that the condition of
the patients and the presence of an unusual complicating infection led
to the high incidence of cardiac involvement. The figures in this last
series are much too high when compared with the frequency of heart
involvement as found by the majority of other investigators.
A number of heart lesions not resulting from influenza were observed.
For none of them was there an antecedent history, but in some cases the
condition may have had an influence in causing accessory cardiac
embarrassment. One case had a chronic interstitial myocarditis of the
rheumatic type, three had mild grades of chronic sclerotic mitral
endocarditis, one a bicuspid pulmonary valve and three showed old
pericardial adhesions, one of them having a complete obliteration of the
sac. The foramen ovale was patent in six of the hearts.
_Arteries_
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