Signs Of Heart Weakness


Categories: Uncategorized
Sources: Disturbances Of The Heart

It should be remembered that a normal heart may slow to about 60

during sleep, and all nervous acceleration of the pulse may be

differentiated during sleep by the fact that if the heart does not

markedly slow, there is cardiac weakness or some general

disturbance. There is also cardiac weakness if there is a tendency

to yawn or to take long breaths after slight exertions or during

exertion, or if there is a feeling of suffocation and the person

suddenly wants the windows open, or cannot work, even for a few

minutes, in a closed room. If these disturbances are purely

functional, exercise not only may be endured, but will relieve some

nervous heart disturbances, while it will aggravate a real heart

disability. If the heart tends to increase in rapidity on lying

down, or the person cannot breathe well or feels suffocated with one

ordinary pillow, the heart shows more or less weakness.

Extrasystoles are due to abnormal irritability of the heart muscle,

and may or may not be noted by the patient. If they are noted, and

he complains of the condition, the prognosis is better than though

he does not note them.



It has long been known that asthma, emphysema, whooping cough, and

prolonged bronchitis with hard coughing will dilate the heart. It

has not been recognized until recently, as shown by Guthrie,

[Footnote: Guthrie, J. B.: Cough Dilatation Time a Measure of Heart

Function, The Journal. A. M. A., Jan. 3, 1914, p. 30.] that even one

attack of more or less hard coughing will temporarily enlarge the

heart. From these slight occurrences, however, the heart quickly

returns to its normal size; but if the coughing is frequently

repeated, the dilatation is more prolonged. This emphasizes the

necessity of supporting the heart in serious pulmonary conditions,

and also the necessity of modifying the intensity of the cough by

necessary drugs.



In deciding that a heart is enlarged by noting the apex beat,

percussion dulness, and by fluoroscopy, it should be remembered that

the apex beat may be several centimeters to the left from the actual

normal point, and yet the heart not be enlarged.



The necessity of protecting the heart in acute infections, and the

seriousness to the heart of infections are emphasized by the present

knowledge that tonsillitis, acute or chronic, and mouth and nose

infections of all kinds can injure the heart muscle. In probably

nearly every case of diphtheria, unless of the mildest type, there

is some myocardial involvement, even if not more than 25 percent of

such cases show clinical symptoms of such heart injury. Tuberculosis

of different parts of the body also, sooner or later, injures the

heart; and the effect of syphilis on the heart is now well

recognized.





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