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Source: Disturbances Of The Heart
If a person has been long accustomed to a slow-acting heart, there
are no symptoms. If the heart has become slowed from disease or from
any acute condition, the patient is likely to feel more or less
faint, perhaps have some dizzines, and often headache, which is
generally relieved by lying down. Sometimes convulsions may occur,
epileptiform in character, due possibly to anemia or irritation of
the brain. If the slow heart does not cause these more serious
symptoms, the patient may feel week and unable to attend to his
ordinary duties. As previously urged an abnormally slow heart after
serious illness should be as carefully cared for as a too rapid
heart under the same conditions. Probably often a myocarditis and
perhaps some fatty degeneration are at the base of such a slowed
heart after serious infections.
A heart which has not always been slow but has gradually become slow
with the progress of hypertension and arteriosclerosis will often
disclose on postmortem examination serious lesions of the coronary
Deficiency in the thyroid secretion will always cause a heart to be
slower than normal. The more marked and serious the hypothyroidism,
the slower the heart is apt to be. When such a condition is
diagnosed, the treatment is thyroid extract; or if the insufficiency
is not great, small doses of an iodid should be given. In either
case it is sometimes astonishing how rapidly a slow, sluggishly
acting heart, improves and how much improvement there is in the
mental condition of the patient.
In acute slowing of the heart, as in syncope, the patient must
immediately lie down with the head low, possibly with the feet and
legs elevated, and all constricting clothing of the abdomen and
chest should be removed. Whiffs of smelling-salts may be given;
whisky, brandy or other quickly acting stimulant, not much diluted,
play also be given. Camphor, a hypodermic dose of strychnin or
atropin if deemed necessary, a hot-water bag over the heart, and
massaging of the arms and legs to aid the return circulation, are
all means which are generally successful in restoring the patient's
circulation to normal. Caffein is another valuable stimulant,
perhaps best administered as a cup of coffee. Digitalis is not
indicated: neither is nitroglycerin, unless the slow heart is due to
cardiac pain or to angina.
Some patients have syncopal attacks with the least injury or with
any mental shock. Such patients as soon as restored are as well as
ever. Other patients who faint or have attacks of syncope should
remain at rest on a couch or bed for some hours.
A tangible cause, being discovered for an unusually slow heart is
sufficiently indicative of the treatment not to require further
comment. While generally toxins from intestinal indigestion make a
heart irritable and more rapid, sometimes they slow a heart, and in
such cases the heart will be improved when catharsis has been caused
and a modification of the diet is ordered.
Next: Paroxysmal Tachycardia