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Myocarditis Fibrous Symptoms And Signs
Source: Disturbances Of The Heart
The symptoms of chronic myocardial degeneration are progressive
weakness, slight at first, noticeable on exertion (and what was not
considered exertion becomes such), as evidenced by slight
palpitation, slight shortness of breath, leg weariness and mental
tire. The heart frequently becomes more rapid, not only with
exertion and change of position to the erect, but even after eating.
Slight cardiac stimulants, as coffee, affect the heart more than
previously; there is some sleeplessness, more or less troublesome,
and more or less indigestion. There may be mental irritability and
some mental deterioration, as shown in various ways. There are
likely to be slight edemas of the lower extremities toward night.
The amount of urine may diminish. A previously high blood pressure
becomes lower. The pulse may be occasionally intermittent, and later
The physical signs often show an enlargement of the heart, with
increased activity at first, from irritability of the heart and a
lack of perfect coordination; later the heart may show typical signs
of weakness. Not infrequently a heart suffering from fibrosis acts
perfectly until some sudden exertion, as lifting, running or serious
illness causes it suddenly to become weak. Such a heart rarely
regains its former strength. This occurs frequently to those who
have supposed themselves to be in perfect physical health. Some
sudden strain which they have previously been able to endure without
injury, such as carrying a weight upstairs, cranking a refractory
engine, pumping up a series of tires, or walking rapidly with a
younger or more active companion, will suddenly give cardiac
distress signals, serious exhaustion and more or less lengthy
prostration, perhaps for an hour or so, or perhaps for several days.
Permanent cardiac weakness may follow, or compensation may again
occur, to be more easily broken later. Slight cardiac pains and
sensations referred to the cardiac region become frequent. Disliking
to lie on the left side, when previously the patient has been able
to sleep on this side without discomfort, is an evidence of cardiac
disturbance. There may be no real pains, but the patient becomes
conscious of his heart, perhaps for the first time in his life. This
alone is an indication of coming trouble.
If these signs and symptoms develop late in life, or at any age with
other symptoms of sclerosis or senility, little can be done
therapeutically except to afford temporary relief and to prevent the
occurrence of acute attacks of cardiac distress or dyspnea. If the
disturbance is really due to chronic cardiac degeneration, the
sooner the patient learns that his ability is restricted, that his
life is narrowed, the better for his future.
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