To the diagnosis of pulmonary artery sclerosis (Ayers disease)

In the clinic of internal medicine, the so-called "blue disease" (Morbus coeruleus) has long been known, characterized by persistent and widespread cyanosis, covering the face, upper body and limbs. The cause of such cyanosis, or, as they are sometimes called, "blackness" (due to the intensity of the cyanotic color), most authors considered congenital heart defects (mainly narrowing of the pulmonary artery), leading to displacement of arterial and venous blood. But, starting from the second half of the 19th century, a number of authors (Lasche, Reich, Aust, Adler, Briand) described cases accompanied by severe cyanosis, shortness of breath and an enlargement of the right stomach, diagnosed by them as congenital defects or defects of mitral valves, and where on the section no defect was found, but pulmonary artery sclerosis was found. The authors drew attention to the fact that in most of these cases there was no general arteriosclerosis or sclerosis of the great circle vessels. This disease began to attract the attention of doctors, and in 1901 Argentine clinician Iersa reported a disease, which he believed to be caused by widespread pulmonary artery sclerosis. The main symptoms of this disease, according to Iers, are: constant and sharp cyanosis of the head, neck, mucous membrane of the tongue, eyes and extremities, severe shortness of breath, polyglobulia, drowsiness and hypertrophy and dilation of the right stomach. The author himself called this disease Cardiacos negros, and in the clinic it received the name "Ayers disease". 7 years later, in 1908, Posselt wrote about 170 cases he collected in the world literature, and about 10 of his own cases, confirmed by autopsies. The diagnosis was made during life in 7 cases. Posselt and other authors (Arrilyaga, Frisoni) supplement the clinical picture described by Ayers with constant headaches, frequent hemoptysis, due to stagnation in the pulmonary circulation, and chest pains accompanied by a feeling of fear and anxiety.