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Categories: Uncategorized
Sources: Disturbances Of The Heart

The symptoms are increased tension, which means, sooner or later,

hypertrophy of the left ventricle and an accentuated closure of the

aortic valve. This alone means more and more tendency to aortic

irritation and aortic valve irritation, with inflammation, and later

deposits of calcareous material, perhaps with stiffening of the

aortic valve and narrowing, aortic stenosis being the result. If

such a patient with the di
ease advanced to this stage must

overwork, or sustains any severe muscle strain, an aneurysm of the

aorta may occur. In the meantime, with the advancing degeneration of

the cerebral arteries, some sudden cerebral congestion, caused by

leaning over, lifting, vomiting or hard coughing, may rupture a

cerebral vessel, and all the symptoms of apoplexy are present. If

small hemorrhages occur in the arterioles of the extremities, of

course the prognosis is not serious. Sometimes some of the smaller

vessels of the brain may become obstructed and cerebral degeneration

occur. If distal vessels become obstructed, as of the toes or feet,

gangrene takes place unless the obstruction occurs at a place where

the collateral circulation could save the part from such a death.

These are some of the ultimate results of serious and final

arteriosclerosis. The more frequent result, when the disease has not

advanced so far, is a failing heart, either from degenerative

myocarditis, coronary sclerosis or dilatation, with all the symptoms

of coronary sclerosis and angina pectoris, or with the symptoms of

failing circulation.

With high blood pressure to the point of beginning endarteritis, a

gradually increasing force of the apex beat occurs, the aortic

closure is accentuated as just described, the pulse is slow, the

tensity of the arteries depends on the stage of the disease, and

when the disease is actually present, the palpable arteries do not

collapse on pressure. They soon lose their elasticity, and if this

occurs in parts which are soft and flexible, the arteries become

more or less tortuous by the force of the blood current twisting and

bending them, owing to the irregularity of their hardening. The

extremities readily become numb, or the part "goes to sleep," as it

is termed. This occurs frequently at night. Sooner or later some

edema of the feet and legs occurs in the latter part of the day.

Sometimes abdominal colic attacks occur, caused by disturbed

circulation. Various disturbances of metabolism may occur, depending

on the circulation in the different organs or on coincident disease,

and the liver, pancreas and kidneys may be affected.

The blood pressure, if taken in the arms especially, may appear

excessively high, but really the actual pressure in the blood

vessels may be low. This is on account of the inability to compress

the hardened arteries. A heart may be weak and actually need

strengthening even while the blood pressure reading is high.

The treatment of this disease is successful only in its prevention,

and consists in treatment of hypertension before arteriosclerosis is

present. When the disease is actually present, there is nothing to

do except for the patient to stop active labor, never to overeat or

overdrink, to prevent, if possible, toxemias from the bowels, to

keep the colon as clean as possible, and for the physician to give

the heart such medicinal aids as seem needed, vasodilators if the

heart is acting too strongly, possibly small doses of cardiac tonics

if the heart is acting weakly; always with the knowledge that a

degenerative myocarditis may be present in considerable amount, or

that coronary sclerosis may be present.

As stated above, coronary sclerosis probably seldom occurs without

more general arteriosclerosis. Obstruction of the coronary arteries,

however, not infrequently occurs at their orifices in conjunction

with sclerosis of that region of the aorta and of the aortic valve.

The more these arteries are diseased and the more they are

obstructed, the more the myocardium of the heart becomes

degenerated, softened and weakened, when dilatation of the

ventricles, especially the left, is liable to occur. Sooner or later

such a condition will cause attacks of angina pectoris and more or

less pronounced symptoms of chronic myocarditis and fatty

degeneration, as previously described.