Disturbances of the Heart: Discussion of the Treatment of the Heart in Its Various Disorders, With a Chapter on Blood PressureOsborne, Oliver T. (Oliver Thomas)
Science
Disturbances of the Heart: Discussion of the Treatment of the Heart in Its Various Disorders, With a Chapter on Blood Pressure
Osborne, Oliver T. (Oliver Thomas)
Blood pressure; Heart -- Diseases
When compensation has been restored, the patient may be allowed
gradually to resume his usual habits and work, provided these habits
are sensible, and the work is not one requiring severe muscular
exertion. Careful rules and regulations must be laid down for him,
depending on his age and the condition of his arteries, kidneys and
heart muscle. It should be remembered that a patient over 40, who
has had broken compensation, is always in more dancer of a
recurrence of this weakness than one who is younger, as after 40 the
blood pressure normally increases in all persons, and this normal
increase may be just too much for a compensating heart which is
overcoming all of the handicap that it can withstand. Such patients,
then, should be more carefully restricted in their habits of life,
and also should have longer and more frequent periods of rest.
The avoidance of all sudden exertion in any instance in which
compensation has just been restored is too important not to be
frequently repeated. The child must be prevented from hard playing,
even running with other children, to say nothing of bicycle riding,
tennis playing, baseball, football, rowing, etc. The older boy and
girl may need to be restricted in their athletic pleasures, and
dancing should often be prohibited. Young adults may generally,
little by little, assume most of their ordinary habits of life; but
carrying heavy weights upstairs, going up more than one flight of
stairs rapidly, hastening or running on the street for any purpose,
and exertion, especially after eating a large meal, must all be
prohibited. Graded physical exercise or athletic work, however, is
essential for the patients' future health, and first walking and
later more energetic exercise may be advisable.
These patients must not become chilled, as they are liable to catch
cold, and a cold with them must not be neglected, as coughing or
lung congestions are always more serious in valvular disease. Their
feet and hands, which are often cold, should be properly clothed to
keep them warm. Chilling of the extremities drives the blood to the
interior of the body, increases congestion there, and by peripheral
contraction raises the general blood pressure. A weak heart
generally needs the blood pressure strengthened, but a compensating
heart rarely needs an increase in peripheral blood pressure, and any
great increase from any reason is a disadvantage to such a heart.
The patient should sleep in a well ventilated room, but should not
suffer the severe exposures that are advocated for pulmonary
tuberculosis, as severe chilling of the body must absolutely be
avoided.
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