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Source: Disturbances Of The Heart
If a more malignant form of endocarditis develops on a mild
endocarditis, the diagnosis is generally not difficult. If, without
a definite known septic process, malignant endocarditis develops,
localized symptoms of heart disturbance and cardiac signs may be
If there is no previous disease with fever, the temperature from
this endocarditis is generally intermittent, accompanied by chills,
with high rises of temperature, even with a return to normal
temperature at times. There may be prostration and profuse sweats.
Even without emboli there may be meningeal symptoms: headache,
restlessness, delirium, dislike of light and noise, and stupor; even
convulsions may occur. The urine generally soon shows albumin; there
may be joint pains; the spleen is enlarged and the liver congested.
Some definite cardiac symptoms are soon in evidence, with more or
less progressive cardiac weakness. Occasionally there are no
symptoms other than the cardiac.
Characteristic of this inflammation is the development of ecchymotic
spots on the surface of the body, especially on the feet and lower
extremities. Sooner or later, in most instances of the severe form
of this disease, emboli from the ulcerations in the heart reach the
different organs of the body, and of course the symptoms will depend
on the place in which the emboli locate. If in the abdomen, there
are colicky pains with disturbances, depending on the organs
affected; if in the brain, there may be paralysis, more or less
complete. In all infaret occurs in one of the organs of the body
there must of necessity occur a necrosis of the part and an added
focus of infection. If a peripheral artery is plugged, gangrene of
the part will generally occur, if the patient lives long enough.
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