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INFARCTION OF THE CARDIAC AURICLES (ATRIA): CLINICAL, PATHOLOGICAL, AND EXPERIMENTAL STUDIES

1942; BMJ; Volume: 4; Issue: 1-2 Linguagem: Inglês

10.1136/hrt.4.1-2.17

1468-201X

E. H. Cushing, Harold Feil, E. J. Stanton, William B. Wartman,

Congenital Heart Disease Studies

Infarction of the auricles * (atria) of the heart is generally considered a rare lesion of little clinical importance and few cases are reported.However, a study of the records at the University Hospitals of Cleveland showed that the auricles were involved in 31 (17.0 per cent) of 182 cases of myocardial infarction that were proven at autopsy during the seven year period from 1934 to 1940.This is the highest incidence of auricular infarction in any reported series, but is thought to be near the true incidence of the lesion, because during the period of investigation the auricles were specifically examined for infarcts.In a previous publication (Feil, Cushing, and Hardesty, 1938) two cases of infarction of the right auricle were encountered in a pathological study of 34 cases of acute myocardial infarction.Bean (1938) reported a series of 300 cases of myocardial infarction in which two instances of auricular infarcts were encountered at autopsy.Auricular fibrillation was present in one of these cases.Clowe, Kellert, and Gorham (1934) described a verified case of rupture of the right auricle.They analysed 54 proved cases that had been reported and found that the rupture had occurred in the right auricle in 70 per cent of them.Laignal-Lavastine, Liber, and Bidou (1934) found a ruptured hmmorrhagic infarct in the right auricle, following thrombosis of the first portion of the right coronary artery and its auricular branches.Clerc and Levy (1925) studied a patient with mitral stenosis and infarction of the external and superior portions of the right auricle.The electrocardiogram showed what they termed " fibrillo-flutter."Lisa and Ring (1931) described rupture of the left auricle in a heart in which there was advanced coronary arteriosclerosis and a recent thrombus in the anterior descending branch of the left coronary artery.Daven- * In the anatomical and pathological portions of this paper, starting with the section headed Pathological Observations on p. 20, a distinction is made between the words " atrium " and " auricle " in accordance with the B.N.A. terminology.Atrium is defined as the entire chamber, either left or right, at the base of the heart above the ventricle.The word " auricle " is reserved for the ear-like appendage of the atrium.In the discussion of the physiological and clinical aspects of the lesion, deference is made to long and common usage so that when the adjective " auricular " is employed it refers to the entire chamber and not to the append- age.Thus such terms as " auricular fibrillation," " auricular flutter " and " auricular mechanism " do not imply localization to the appendage.