While working on a sermon the pastor heard a knock at his office door. "Come in," he invited. A sad-looking man in threadbare clothes came in, pulling a large pig on a rope. "Can I talk to you for a minute?" asked the ma... Read more of Frog Jokes at Free Jokes.caInformational Site Network Informational
Privacy


Home


Medical Articles


Mother's Remedies


Household Tips


Medicine History


Forgotten Remedies


Search

Medical Articles

The Development Of Allergies

There are three ways a body can become allergic. (1) It can h...

Rest

In every person there is a certain amount only of force which i...

Extraction Of Open Safety-pins From The Esophagus

An open safety pin with the point down offers no particular ...

Accidents And Emergencies

Ordinarily, Accidents are not Serious. Accidents will happe...

The Relative Anatomy Of The Male Pelvic Organs

As the abdomen and pelvis form one general cavity, the organs...

Wounds Soothing

During the process of healing, wounds often give a great deal ...

Removal Of Open Safety Pins From The Trachea And Bronchi

Removal of a closed safety pin presents no difficulty if it i...

The Throat Should Be Covered With A Wet Compress I E A Piece Of

linen four to eightfold, according to its original thickness, d...

Burns Case Xxxiii

A little girl, aged 10, scalded her breast a week ago and has...

Food And Mental Power

Unsuitable or ill-cooked food has a most serious effect on the...

Internal Relaxation

Pain is often felt in parts of the back or sides which will yi...

Coughs

These will be found treated under the various heads of Colds, ...

Our Relations With Others

EVERY one will admit that our relations to others sho...

To Prevent Colds

Keep the _arms_, _hands_ and _chest_ well clothed and warm. ...

The Triviality Of Trivialities

LIFE is clearer, happier, and easier for us as things assume ...

Nervous Strain In Pain And Sickness

THERE is no way in which superfluous and dangerous te...

Choice Of Time To Do Bronchoscopy For Foreign Body

The difficulties of removal usually increase from the time of...

Removal Of Foreign Bodies From The Larynx

Symptoms and Diagnosis.--The history of a sudden choking atta...

Expectoration

What is commonly called a "cough and spit" is sometimes due to...

Artistic Considerations

ALTHOUGH so much time and care are given to the vario...



Acute Dilatation Of The Heart In Acute Disease





Category: Uncategorized
Source: Disturbances Of The Heart

It has for a long time been recognized that in all acute prolonged
illness the heart fails, sooner or later, often without its having
been attacked by the disease. The prolonged high temperature causes
the heart to beat more rapidly, while the toxins produced by the
fever process cause muscle degeneration of the heart or a
myocarditis, and at the same time the nutrition of the heart becomes
impaired either by improper feeding or by the imperfect metabolism
of the food given; hence the heart muscle becomes weakened, and
cardiac failure or cardiac relaxation or dilatation occurs.

The specific germ of the disease, or the toxin elaborated by this
germ, may be especially depressant to the heart, as in diphtheria,
or the germ may be particularly prone to locate in the heart, as in
rheumatism and pneumonia. But all feverish processes, sooner or
later, if sufficiently prolonged, cause serious cardiac weakness and
more or less dilatation.

Just exactly what changes take place in the muscle fibers of the
heart in some of these fevers has not been decided. Whether an
albuminous or parenchymatous degeneration of the muscle fibers or a
fatty degeneration occurs, whether there is a real myocarditis that
always precedes the dilatation, or whether the weakening and loss of
muscle fibers or a diminished power of the muscle fibers occurs
without inflammation, dilatation of the heart is always a factor to
be considered, and frequently occurs in acute disease.

While it is denied that acute dilatation can occur in a sound heart,
at the latter end of a serious illness the heart is never sound, and
acute dilatation can most readily occur, though fortunately it is
generally preventable. When the dilatation occurs suddenly, as
indicated by a fluttering heart, a low tension, rapid pulse, dyspnea
and perhaps cyanosis with venous stasis in the capillaries, death is
imminent, although such patients may be saved by proper aid. Even
when the dilatation is slower, as evidenced by a gradually
increasing rapidity of the heart and a gradually lowering blood
pressure, and with more evidences of exhaustion, death may occur
from such heart failure in spite of all treatment.

Unless a patient dies from accident, as from a hemorrhage, from
cerebral pressure or from some organic lesion in acute disease, the
physician frequently feels that if he can hold the power and force
of the circulation for several hours or days, the patient will
recover from the disease, for in most acute diseases the patient has
a good chance of recovery if his circulation will only hold out
until the crisis has occurred or until the disease is ready to end
by lysis. Therefore anything during the disease that tends to
sustain, nourish, quiet and guard the heart means so much more
chance of recovery, whatever else may or may not be done for the
disease itself.

The best treatment of dilatation of the heart in acute disease is
its prevention, and to prevent it means to recognize the condition
which can cause it. These are

1. Prolonged high temperature. A short-lived temperature, even if
high, is not serious. Prolonged temperature of even 103 F. or more
is serious, and even that of 101 is serious if too long continued.

2. Exertion and excitement. Every possible means should be
inaugurated to prevent muscular exertion and strain of the patient
while in bed. Proper help in lifting and turning the patient should
be employed, the bed-pan should be used, proper feeding methods
should be adopted, and friends should be excluded so that the
patient may not be excited by conversation.

3. Bad feeding. The diet should of course be sufficient, for the
patient and proper for the disease, but any diet which causes a
large amount of gas in the stomach, or tympanites, is harmful to the
patient's circulation, to say nothing of any other harm, such as
indigestion may do. All of the nutriments needed to keep the body in
perfect condition should be given to a patient who is ill; in some
manner he should receive the proper amounts of iron, salt, calcium,
starch, protein, sugar and water.

4. Intestinal sluggishness. This means not only that tympanites
should not be allowed, but also that necessary laxatives should be
given. It would be wrong to prostrate a patient with frequent saline
purgatives, but the bowels must move at least once every other day,
generally better daily; and if the case is one of typhoid fever,
they should be moved by some carefully selected laxative, and after
the bowels have sufficiently moved, the diarrhea should be stopped
by 1/10 grain of morphin, and the next day the bowels properly moved
again.

5. Depressant drugs. In this age of cardiac failure, heart
depressants of all types, and especially the synthetic products,
should be given only with careful judgment, and, never frequently
repeated or long continued.

6. Pain. This is one of the most serious depressants a heart has to
combat; acute pain must not be allowed, and prolonged subacute pain
must be stopped. Even peripheral troublesome irritations must be
removed, as tending to wear out a heart which has all of the trouble
it can endure.

7. Insomnia. Nothing rests a heart or recuperates a heart more than
sleep. Insomnia and acute disease make a combination which will wear
a heart out more quickly than any other combination. Sleep, then,
must be produced in the best, easiest and safest manner possible.

8. A too speedy return to activity. The convalescence must be
prolonged until the heart is able to sustain the work required of
it.

The treatment of gradual dilatation in acute disease has been
sufficiently discussed under the subject of acute myocarditis. The
treatment of acute dilatation is practically the same as the
treatment of shock plus whatever treatment must coincidently be
given to a patient for the disease with which he is suffering. The
treatment of shock will be discussed under a separate heading.





Next: The Heart In Pneumonia

Previous: Simple Dilatation



Add to del.icio.us Add to Reddit Add to Digg Add to Del.icio.us Add to Google Add to Twitter Add to Stumble Upon
Add to Informational Site Network
Report
Privacy
SHAREADD TO EBOOK


Viewed 1749