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March 1, 1924


JAMA. 1924;82(9):716. doi:10.1001/jama.1924.26520350003018a

The accompanying illustration shows a heart weighing 480 gm., which in situ was lying free on the left lung. No pericardium was visible except a triangular-shaped flap, which blended with the epicardium over the right side of the heart and was attached at the apex and near the emergence of the major arteries. The posterior portion of the heart was entirely devoid of pericardium. There was one other curiosity in the chest wall, namely, unequal fat deposit over the sternum; the right side scantily, the left side richly padded. It was thought that the continued beat of the uncovered heart against this portion of the chest might have interfered with the blood supply and contributed to the fracture of a rib before the patient's death.

The patient, aged 56, had general paralysis. The heart action was never attended by any known clinical irregularity, though there was no pericardial fluid. No