A Cardiac Clinico-Pathological Conference in 1882: An Historical Vignette

Abstract

In the Australian Medical Journal of March 1883, there is a report entitled, “ Valvular incompetency of pulmonary artery, with regurgitation”, presented by Dr. William Pegus. Dr. Pegus presented this paper about his own peculiar heart problem, which was different from any in the textbooks of that time, to a group of doctors in 1882. He described his symptoms, the progress of the condition and the treatment he received, the most helpful of which was the use of Turkish baths. There was discussion on the possible diagnosis but at the conclusion of the presentation it was felt that all the symptoms could not be explained and therefore the diagnosis was uncertain. In the light of present day knowledge, the clinical picture is typical of a rupture of aneurysm of a sinus of Valsalva into the right ventricle. Rupture of such an aneurysm was first described by Hope in 1839 in his book on diseases of the heart and great vessels, the diagnosis being made at autopsy. Dr. Pegus was probably the first person in Australia to publish a detailed description of the symptoms and clinical signs and to give an account of the progress of the condition with his own thoughts about the treatment available at the time.