Changes in the finger nails of patients with cardiac disease are caused principally by congestion in the venous system. The bluish discoloration of the nails is a symptom well known to every physician. When the congestion persists for some time, the matrix bulges while the nail bed and nail wall manifest less conspicuous changes. The process results in the formation of "hippocratic" nails and of clubbed fingers.
According to Heller,1 the eminent authority on diseases of the nail, all other changes in the nail in patients with cardiac involvement must be regarded as great rarities. Subungual keratosis is occasionally observed. Only in 1 case of myocarditis Heller observed broad transverse furrows (the so-called Beau lines). These transverse sulci had made their appearance seven and five months previously, at a time when the patient was suffering severe general manifestations, notably high grade edema.
URBACH E. WHITE CROSS STRIAE OF THE FINGER NAILS FOLLOWING CARDIAC INFARCTION. Arch Derm Syphilol. 1945;52(2):106–107. doi:10.1001/archderm.1945.01510260036007
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