Historical perspective on the natural history of congenital aortic stenosis, highlighting the limitations of early case reports and the impact of early surgical interventions on understanding the disease's natural progression.
Our knowledge of the natural history of most malformations of the heart is far from complete, mainly because their clinical diagnosis interested so few physicians for any length of time before their surgical treatment became possible. This hampered the study of their natural history because the more severe cases, in varying degrees, were sub- mitted to operation, and most early papers were reports of one or two cases with necropsies. Thus, Thursfield and Scott (1913) reported the sudden death of a boy of 14 with subaortic stenosis: 7 years earlier the diagnosis had been a ventricular septal defect. Christian (1933) reported two congenital defects, one subvalvar in a man of 40 and the other valvar in a man of 27 years, both of whom had died.
M Campbell (Mon,) studied this question.