Acute Cardiac Symptoms Acute Heart Attack
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Disturbances Of The Heart
It is not proposed here to describe the condition of sudden cardiac
failure, or acute dilatation during disease, or after a severe heart
strain, but to describe the terrible cardiac agony which occurs,
sometimes repeatedly, with many patients who have valvular lesions.
These patients may not have the symptoms of loss of compensation.
Probably some one or more chambers of the heart become overdistended
and act irregular
y, or the blood is suddenly dammed up in the
lungs, with the oppression and dyspnea caused by such passive
congestion, or perhaps it is the right ventricle that is suddenly in
serious trouble.
A physician receives an emergency call, and knows, if it is not a
patient who has hysteria, that it is his duty to see the patient
immediately. The friends of the patient all anxiously await the
physician's arrival; front doors are often wide open, and the
servants and the whole household are in a great state of excitement
and anxiety. The position in which the patient will be found is that
which he has learned gives him the greatest comfort. If the
physician knows his patient, he will know how he will find him. He
may lie sitting up in bed; he may be standing, leaning over a chair;
he may be sitting in a chair leaning over a table or leaning over
the back of another chair; but he is using every auxiliary muscle he
possesses to respire. He is generally bathed in cold perspiration;
the extremities are often icy cold; he calls for air, and to stop
fanning all in one breath; he wishes the perspiration wiped off his
brow, and nearly goes frantic while it is being done; there is agony
depicted on his face; his eyes stare; his expirations are often
groaning. Sometimes there is even incontinence of urine and feces,
often hiccup or short coughs, perhaps vomiting, and possibly sharp
pangs of pain in the cardiac region. A patient with these symptoms
may die at any moment, and the wonder is that so many times one
lives through these paroxysms.
The patient can hardly be questioned, can certainly not be carefully
examined; and herein lies the advantage of the family physician who
knows the patient and his heart, and in whom the patient has
confidence.
In fact, this confidence which such a patient has in the physician
who has more or less frequently aided him in weathering these
terrible attacks is alone the greatest boon the patient can have.