Sources: Disturbances Of The Heart
Next in frequency to mitral insufficiency is aortic insufficiency,
which occurs most frequently in men. The cavity of the heart that is
most affected by this lesion is the left ventricle, which receives
blood both from the left auricle, and regurgitantly from the aorta.
This part of the heart, being the strongest muscular portion, is the
part most adapted to hypertrophy, and the hypertrophy with this
lesion is often enormous. For a long time this large muscular
section of the heart can overcome all difficulties of the aortic
insufficiency. The pulse, however, will always show the quickly lost
arterial pressure of every beat on account of the aorta losing its
pressure through the regurgitant flow of blood. Sooner or later,
from the impaired aortic tension causing a diminished or imperfect
flow of blood through the coronary arteries, impaired nutrition of
the heart muscle occurs. In other words, an intestinal or chronic
myocarditis or fibrosis develops, with perhaps later a fatty
degeneration. When this condition occurs, of course, the repair of
the heart is impossible.
This form of valvular lesion is the one that is most likely to cause
sudden death. In aortic regurgitation Nature causes the heart to
beat rapidly. Such a heart must never beat slowly, as the longer the
diastole prevails the more blood will regurgitate into the left
ventricle, and death may occur from sudden anemia of the base of the
brain. Such a heart may, of course, receive a sudden strain, or the
left ventricle may dilate, and yet serious myocarditis or fatty
degeneration may not have occurred.
The signs of lack of compensation are generally cardiac distress,
rapid heart, insufficiency of the systolic force of the left
ventricle, and therefore impaired peripheral circulation, a sluggish
return circulation, pendent edemas, and soon, with the left auricle
finding the left ventricle. insufficiently emptied, the damming back
of the blood is in broken compensation with the mitral lesions.