Chronic Myocarditis Fibrous


Categories: Uncategorized
Sources: Disturbances Of The Heart

Chronic myocarditis may develop on an acute myocarditis, but is

generally a slowly progressive chronic process from the beginning;

it occurs mostly in persons past middle life, and as a rule is not

primarily associated with rheumatism or valvular disease of the

heart. Perhaps generally the term "chronic myocarditis" is

incorrect, as a real inflammatory condition is not present and has

not been present; it is really a degenerative process with the

development of connective tissue, a fibrosis and more or less

hardening of the arterioles, a cardiosclerosis. In many instances

this fibrosis is associated with fat deposits or fatty degeneration.

The disease is often caused by a narrowing or obstruction or

calcareous degeneration of the coronary arteries, thus diminishing

the blood supply to the heart muscle. This chronic myocardial

degeneration is often a part of the general arteriosclerosis, and is

an important factor in what is termed cardiovascular-renal disease.

In simple chronic renal diseases the heart first normally

hypertrophies to overcome the increased blood tension and increased

resistance.



The principal causes of this degeneration are normal old age, or

premature age caused by various conditions. In other words, anything

which hastens arteriosclerosis will cause myocardial degeneration.

The causes recognized as most frequently producing this condition

are syphilis; gout; repeated attacks of rheumatism; excess in the

use of alcohol (meaning repeated daily too large amounts, as well as

actual dipsomania); the overuse of tobacco; excess in drinking tea

or coffee; general overeating, and excessive eating of meat in

particular, if the organs of elimination do not work perfectly and

if such eating causes or allows putrefactive changes in the

intestines; and progressive, prolonged wasting diseases, such as

tuberculosis and cancer. It has also seemed in some cases that the

only cause was excessive, hard physical labor, including excessive

athletic work, and in other cases that prolonged anxiety and worry

have been causes of cardiac degeneration and actual cardiac failure.

Prolonged absorption of toxins from mouth and tonsil infections may

be a not infrequent cause.



These myocardial changes are sometimes associated with chronic

pericarditis and chronic endocarditis, and may accompany or follow

valvular disease of the heart. Failure of compensation in valvular

disease and dilatation of the heart are sequences which occur sooner

or later.





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