This study attempts to bring into focus certain details which have not been described adequately in textbooks of anatomy. This

A clinicopathologic study of 51 cases of mitral stenosis with intracardiac mural thrombi is presented with particular reference to the locations of these thrombi and their relationship to the associated thromboembolic phenomena. In 27 cases the thrombi were present only in the left side of the heart, in 15 cases they were in both sides of the heart, and in 9 cases they were present only in the right atrium. Of 42 cases in which thrombi were located in the left side of the heart, in 20 the thrombi were limited to the left auricular appendage. In the remaining 22 cases in this group the thrombi in the left side of the heart were situated on the main atrial wall, in the auricular appendage and on the main atrial wall together, or in the left ventricle. Systemic arterial emboli occurred frequently regardless of the particular site in the left side of the heart at which the thrombus formed. Of 24 cases in which thrombi were situated in the right side of the heart, in 20 the thrombi were restricted to the right auricular appendage. ARTERIAL embolism is

No abstract

may l)e an integral part of the picture of congestive heart failure. Of 161 patients in whom the histologic renal findings were considered to be either normal or to be of such a nature as not to be responsible in themselves for albuminuria, and in wholn clinically-obvious causes for albuminuria had been eliminated, 141, or 88 per cent, had albuminuria. The incidence of albuminuria was about equal among the various types of heart disease when heart failure existed. A trendl existecl for the grade of albuminuria to parallel the grade of heart failure. Based on a study of 21 patients, there seemed to be a correlation between the grade of albuminuria and the group of hypertension, according to funduscopic examination. No correlation was found between the grade of ailbuminuria on one handl and the systolic or diastolic values for blood pressure, the known duration of elevated blood pressure, the grades of hemiaturia or the values for blood urea on the other hand. Among the 161 patients with heart failure in our group 1 (kidneys either normal or containing lesions lnot judged to be causes for albuminuria), there wvas no predominant renail lesion associated wvith aeny v one cardiac lesion.A IBUIJMINUI{TA has been observed commonly in the presence of congestive heart failure. In a given case of conigestivre heart failure, the presence of albuminuria raises the (question as to whether it is a reflection of independent renal disease or simply one aspect of the cardiac failure.A heart failure were first verified by a review of the clinical records. Next, for a given case to he eligible for in(lusion, it was necessary that urinalvsis had been (lone at the same time as the examination at which a diagnosis of congestive heart failure had l)eenl madle. Clinically, there was no obvious cause for alhumiinuria other than congestive heart failure at the time congestive heart failure was(diagnose(l.In the plesent studv, albuminuria was graded on the basis of 1 to 4. The Section of Clinical Pathology of the Mayo Clinic, in which these urinialvses wvere made,' has determined grade 1 albuminuria to represent 5 to 20 mg. of albumin per 100 ml. of urine; gra(le 2: 30 to 50 ing. per 100 mnl.; grade 3: 60 to 90 liug. per 100 ml.; anll grade 4: more than 100 ilg. per 100 ml.On the basis of the above criteria, 212 cases of congestive heart failure in which necropsy hadlbeen done were studied. The clinical recordis were reviewed tand pertinent information was extracted.The necropsv records were reviewed for the classification of the heart disease, the manifestations of congestive heart failure .land evidence of gross abnormalities of the kidneys.On the basis of the clinical and pathologic data, a system of gradation of heart failure was evolved.The heart failure of each lpatient was graded from 1 to 4. In addition, the heart disease of each patient was l)laced in one of the following six categories:(1) mnitral-valve (lisease, with or without aortic stenosis; (2) (oronary arterial (lisease, with or without hypertension; (3) isolated aortic-va...

No abstract