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Hepar Sulphur

is a specific for _Itch and Scald Head,_ applied in form of a...

Drinks Refreshing

This is a matter of great importance to the sick. Nor is anyth...

Brain Rest

The need for this is often indicated by irritability of temper...

Bruises

For slight bruises, such as children frequently get by falling...

Vital Forces Animal And Vegetable

Upon these points I must be permitted to offer a few words. ...

Nettle Rash

This is an eruption on the skin, often coming suddenly and goi...

Hooping Cough

According to my experience, though this disease may not be en...

Pathology

If the foreign body completely obstructs a main bronchus, pr...

The Relative Position Of The Deeper Organs Of The Thorax And Those Of The Abdomen

The size or capacity of the thorax in relation to that of the...

Endoscopy On The Human Being

Dog work offers but little practice in laryngoscopy. Because...

Bowels Lax

A teaspoonful of lemon juice (freshly expressed), along with h...

Mouth-gag

Wide gagging prevents proper exposure of the larynx by forci...

The Surgical Form Of The Deep Cervical And Facial Regions And The Relative Position Of The Principal Bloodvessels And Nerves

While the human cervix is still extended in surgical position...

Itch

I shall say but little about this very common and very obstin...

Sitz-bath Anchor Of Safety

If there be much delirium, the sitz-bath may be required long...

Bruises Case Xviii

Mrs. C. aged 40, was detained on a journey by a bruised wound...

Limbs Inflamed

Entirely different treatment from the above is needed for such...

Wine And Water If No Reaction Can Be Obtained

Should the patient remain cold in his pack for longer than an...

Perversions In The Guidance Of The Body

SO evident are the various, the numberless perversion...

The Relation Of The Principal Bloodvessels Of The Thorax And Abdomen To The Osseous Skeleton Etc

The arterial system of vessels assumes, in all cases, somewha...



Mitral Insufficiency: Mitral Regurgitation





Category: Uncategorized
Source: Disturbances Of The Heart

This is the most frequent form of valvular disease of the heart, and
is due to a shortening or thickening of the valves, or to some
adhesion which does not permit the valve, to close properly, and the
blood consequently regurgitates from the left ventricle into the
left auricle during the contraction of the ventricle. Such
regurgitation may occur without valvular disease if for any reason
the left ventricle becomes dilated sufficiently to cause the valve
to be insufficient. Such a dilatation can generally be cured by rest
and treatment. As with mitral stenosis, the most frequent causes are
rheumatism and chorea, with the occasional other causes as
previously enumerated.

The characteristic murmur of this lesion is a systolic blow,
accentuated at the apex, transmitted to the left of the thorax,
generally heard in the back, near the lower end of the scapula, and
transmitted upward over the precordia.

Of all cardiac lesions, this is the safest one to have. Sudden death
is unusual, the compensation of the heart seems to be most readily
maintained, and the patient is not so greatly dangered by
overexertion or by inflammations in the lungs. As in mitral
stenosis, any increase in blood pressure--whether the normal
increase after the age of 40, any continued earlier high tension, or
increase from occupation or exercise--is serious as causing the left
ventricle to act more strenuously, so that more blood is forced back
into the left auricle, the lungs become congested, and the right
ventricle, sooner or later, becomes incompetent.

When compensation fails with these patients, the first sign is
pendent edema of the feet, ankles and legs; subsequently, if there
is progressive failure of compensation, the usual symptoms occur.

The treatment is principally rest and digitalis, and the recovery of
compensation is often almost phenomenal. Patients with this lesion
are likely to be children and young adults, and the heart muscle
readily responds as a rule to the treatment inaugurated. Later, in
these patients, or if the lesion occurs in older patients, the
return to compensation does not occur so readily. If the condition
is developed from a myocarditis or from fatty degeneration of the
heart, it may be impossible to cause the left ventricle to improve
so much as to overcome this relative dilatation or relative
insufficiency of the valve. If the dilatation of the left ventricle
is due to some poisoning such as nicotin, with proper treatment--
stopping the use of tobacco, administration of digitalis, and rest--
the heart muscle will generally recover and the valve again properly
close.





Next: Aortic Stenosis Aortic Obstruction

Previous: Mitral Stenosis: Mitral Narrowing



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