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Diagnosis

Categories: Uncategorized
Sources: Disturbances Of The Heart

If a more malignant form of endocarditis develops on a mild

endocarditis, the diagnosis is generally not difficult. If, without

a definite known septic process, malignant endocarditis develops,

localized symptoms of heart disturbance and cardiac signs may be

very indefinite.



If there is no previous disease with fever, the temperature from

this endocarditis is generally intermittent, accompanied by chills,
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with high rises of temperature, even with a return to normal

temperature at times. There may be prostration and profuse sweats.

Even without emboli there may be meningeal symptoms: headache,

restlessness, delirium, dislike of light and noise, and stupor; even

convulsions may occur. The urine generally soon shows albumin; there

may be joint pains; the spleen is enlarged and the liver congested.

Some definite cardiac symptoms are soon in evidence, with more or

less progressive cardiac weakness. Occasionally there are no

symptoms other than the cardiac.



Characteristic of this inflammation is the development of ecchymotic

spots on the surface of the body, especially on the feet and lower

extremities. Sooner or later, in most instances of the severe form

of this disease, emboli from the ulcerations in the heart reach the

different organs of the body, and of course the symptoms will depend

on the place in which the emboli locate. If in the abdomen, there

are colicky pains with disturbances, depending on the organs

affected; if in the brain, there may be paralysis, more or less

complete. In all infaret occurs in one of the organs of the body

there must of necessity occur a necrosis of the part and an added

focus of infection. If a peripheral artery is plugged, gangrene of

the part will generally occur, if the patient lives long enough.



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