Myocardial Disturbances


Categories: Uncategorized
Sources: Disturbances Of The Heart

While the myocardium is the most important muscle structure of the

body, it has but recently been studied carefully or well understood

clinically or pathologically. A heart was "hypertrophied" or

"dilated" or perhaps "fatty." It suffered from "pain," "angina

pectoris," from some "serious weakness" or from "coronary disease,"

and that ended the pathology and the clinical diagnosis. This is the

age of heart defects; no one can understand a patient's condition

now, whatever ails him, without studying his heart. No one can treat

a patient properly now without considering the management of the

circulation. No one should administer a drug now without considering

what it will do to the patient's heart.



Although we are scientifically interested in the administration of

specific treatments, antitoxins and vaccines; although we have a

better understanding of food values, and order diets with more

careful consideration of the exact needs of the individual, and

although we are using various physical methods to promote

elimination of toxins, poisons and products of metabolism, we have

until lately forgotten the physical fact that one thirteenth of the

weight of a normal adult is blood. A man who weighs 170 pounds has

13 pounds of blood. This proportion is not true in the obese, and is

not true in children. Whether the person is sick in bed, miserable

though up and about, or beginning to feel the first sensations of

slight incapacity for his life work, his ability properly to

circulate this one thirteenth of his weight through the various

arterial and venous channels and capillary tracts must, with the

increasing tension and speed of our lives, be taken into

consideration.



The more and more frequently repeated statements that the operation

was successfully performed but that the patient died of shock, and

that the typhoid fever and the pneumonia were being successfully

combated, but that the patient died of heart failure, together with

the increase in arteriosclerosis, cardiac disturbances and renal

disease, emphatically present the necessity of more carefully

studying the circulation. A better understanding and the constant

study of the blood pressure shows nothing but the necessity of the

age. The unwillingness of the patient to suffer pain, even for a few

minutes, without some narcotic, generally a cardiac debilitating

drug, means that, if he is a sufferer from chronic or recurrent

pain, he has taken a great deal of medicine which has done his heart

no good. Repeated high tension of life raises the blood pressure and

puts more work on the heart. Therefore the heart is found weary, if

not actually degenerated, when any serious accident, medical or

surgical, happens to the patient.



The requirements of the age have, then, necessitated that the heart

be more carefully studied, and therefore the heart strength and its

disturbances are better understood. The mere determination as to

where the apex beat is located, and as to what murmurs may be

present is not sufficient; we must attempt to determine the probable

condition of the myocardium. The following conditions are

recognized: (1) acute myocarditis, (2) chronic myocarditis

(fibrosis, cardiosclerosis), (3) fatty degeneration, and (4) fatty

heart.





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