The longest period during which any patient
survived the injury was fourteen hours.
Among the older writers who note this traumatic injury are Fine,
who mentions concussion rupturing the right ventricle, and
Ludwig, who reports a similar accident. Johnson mentions rupture
of the left ventricle in a paroxysm of epilepsy. There is another
species of rupture of the heart which is not traumatic, in which
the rupture occurs spontaneously, the predisposing cause being
fatty degeneration, dilatation, or some other pathologic process
in the cardiac substance. It is quite possible that the older
instances of what was known as "broken-heart," which is still a
by-word, were really cases in which violent emotion had produced
rupture of a degenerated cardiac wall. Wright gives a case of
spontaneous rupture of the heart in which death did not occur for
forty-eight hours. Barth has collected 24 cases of spontaneous
rupture of the heart, and in every instance the seat of lesion
was in the left ventricle. It was noticed that in some of these
cases the rupture did not take place all at once, but by repeated
minor lacerations, death not ensuing in some instances for from
two to eleven days after the first manifestation of serious
symptoms.
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