Aneurism of the Pulmonary Artery.

Aneurism of the pulmonary artery is very rare, and is usually sacculated or fusiform; extreme dilatation, however, is not uncommon, and may result from mitral stenosis, phthisis, emphysema, or any affection that obstructs the lesser circulation. When extreme, there will be insufficiency of the semilunar valves.

Symptoms.—If the aneurism be large, the symptoms will be similar to those of aneurism of the thoracic aorta; usually, however, the aneurism is small and the symptoms are negative. If there be extreme dilatation, there will be regurgitation into the right ventricle, which will be attended by cyanosis, dyspnea, and more or less cough.

Physical examination reveals a pulsation in the second or third interspace and to the left of the sternum. On palpation, the systolic pulsation is attended by a thrill and diastolic shock.

Percussion reveals a dull or flat sound, over the area of pulsation (second interspace). We are to remember, however, that where there is retraction of the lung, the percussion note will be dull, though neither dilatation nor aneurism exist.

Auscultation may reveal a loud, superficial, systolic murmur to the left of the sternum, over the second interspace.

The prognosis is unfavorable, and the treatment will be on the same principles as outlined for thoracic aneurism.

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