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Medical ArticlesNight PainsIf these are of the nature of cramps, which come on while lyin... Treatment In this rapid high tension age the physician should be as ene... Head Baths See Baths for Head. ... Mitral Insufficiency: Mitral Regurgitation This is the most frequent form of valvular disease of the hea... Erysipelas Take the A. D. current, medium force, in all forms of the dis... How To Sew Easily IT is a common saying that we should let our heads sa... Others HOW to live at peace with others is a problem which, if pract... Dyspepsia This is one of the most difficult of diseases to control by a... Instruments For Direct Laryngoscopy In undertaking direct laryngoscopy one must always be prepar... The Surgical Dissection Of The Wrist And Hand A member of such vast importance as the human hand necessaril... Extraction Of Tacks Nails And Large Headed Foreign Bodies From The Tracheobronchial Tree In cases of this sort the point presents the same difficulty... Contraction Of Sinews This often occurs at the knee, bending the joint so that the p... Starvation It is true that ethical medical doctors use the least-risky ... Calendula is applied to wounds, _incised_ and _lacerated_, promoting he... Technic The patient should be placed in the recumbent position, with... Nose Bleed - Epistaxis If it arises from fullness of the vessels of the head, with t... Punctures Case Iv The present case is somewhat more severe than those which hav... Hair Coming Off There are many forms of this disfiguring trouble, both in the ... Liver The Where biliousness prevails, without any symptom of real liver ... Alcohol It is rarely, if ever, advisable to use alcohol. In certain ... |
Pathologic PhysiologyCategory: Uncategorized Source: Disturbances Of The Heart The development of permanent injury to one or more valves of the heart may have been watched by the physician who cares for a patient with acute endocarditis, or it may have been noted early during the progress of arteriosclerosis or other conditions of hypertension. On the other hand, many instances of valvular lesions may be found during a life-insurance examination, or are discovered by the physician making a general physical examination for an indefinable general disturbance or for local symptoms. without the patient ever having known that he had a damaged heart. The previous history of such a patient will generally disclose the pathologic cause or the physical excuse. As soon as a valve has become injured the heart muscle hypertrophies to force the blood through a narrowed orifice or to evacuate the blood coming into a compartment of the heart from two directions instead of one, as occurs in regurgitation or insufficiency of a valve. The heart muscle becomes hypertrophied, like any other muscle which is compelled to do extra work. Which part or parts of the heart will become most enlarged depends on the particular valvular lesion. In some instances this enlargement is enormous, increasing a heart which normally weighs from 10 to 12 ounces to a weight of 20 or even 25 ounces, and extreme weights of from 40 to 50 ounces and even more are recorded. As long as the heart remains in this hypertrophied condition, which may be called normal hypertrophy since it is needed for the work which has to be done in overcoming the defect in the valve, there are no symptoms, the pulmonary and systemic circulation is sufficient, and the patient does not know that he is incapacitated. Sooner or later, however, the nutrition of the heart, especially in atheromatous conditions, becomes impaired, and the lack of a proper blood supply to the heart muscle causes myocardial disturbance, either a chronic myocarditis or fatty degeneration. If there is no atheromatous condition of the coronary arteries, and arterial disease is not a cause of the valvular lesion, compensation may be broken by some sudden extra strain put on the heart, either muscular or by some acute sickness or a necessary anesthetic and operation. From any of these causes the muscle again becomes impaired, and the heart, especially the part which is the weakest and has the most work to do relatively to its strength, becomes dilated, compensation is broken, and all of the various circulatory disturbances resulting from an insufficient heart strength develop. Next: Precautions To Be Observed Previous: Etiology Treatment
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