Chronic Endocarditis


Categories: Uncategorized
Sources: Disturbances Of The Heart

It is not easy to decide just whew all acute endocarditis has

entirely subsided and a chronic, slow-going inflammation is

substituted. It would perhaps be better to consider a slow-going

inflammatory process subsequent to acute endocarditis as a subacute

endocarditis; and an infective process may persist in the

endocardium, especially in the region of the valves, for many weeks

or perhaps months, with some fever, occasional chills, gradually

increasing valvular lesions and more or less general debility and

systemic symptoms. Such a subacute endocarditis may develop

insidiously on a previously presumably healed endocardial lesion and

cause symptoms which would not be associated with the heart, if an

examination were not made. Sometimes such a slow-going inflammatory

process will be associated with irregular and intangible chest

pains, with some cough or with many symptoms referred to the

stomach, so that the stomach may be considered the organ which is at

fault. There may be dizziness, headache, feelings of faintness,

sleeplessness, progressive debility and a persistent cough, with

some bronchial irritation and with occasional expectoration of

streaks of blood, which may cause the diagnosis of incipient

tuberculosis to be made. The need of a careful general examination

must be emphasized again before a decision is made as to what ails

the patient, or before cough mixtures are given unnecessarily,

quinin is prescribed for supposed malarial chills, or various diets

and digestants are recommended for a supposed gastric disturbance.



The term "chronic endocarditis" should be reserved for a slowly

developing sclerosis of the vavles. This may occur in a previous

rheumatic heart and in a heart which has suffered endocarditis and

has valvular lesions, or it may occur from valvular strain or heart

strain from various causes; it is typically a part of the

arteriosclerotic process of age, and is then mostly manifested at

the aortic valve.





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