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
If a child has had an attack of heart inflammation, a myocarditis or
an endocarditis, greater care should be taken of him not only when
he is well but especially when he becomes ill of any other disease.
If the child has had a rheumatic inflammation of the heart, or has
had rheumatism without such a complication, it is considered by some
clinicians wise to give a week's treatment with salicylates at
intervals of three or four months, for two or three years, perhaps.
It is hard to determine how much value this prophylactic treatment
has. If the child's surroundings cannot be changed and lie is
subjected to the same conditions of possible reinfection, it may be
a wise precaution, much like the prophylactic administration of
quinin in malarial regions. If a child has developed a cardiac
inflammation during any disease, the treatment is that previously
outlined.
An important part of prophylaxis and treatment of a cardiac
affection during the course of any disease is the prevention of
serious anemia. During sickness the patient is liable to become more
or less anemic, but the administration of iron, in the manner
previously suggested, during the course of the disease, and
especially during rheumatism, will prevent the anemia becoming rapid
or severe.
CARDIAC DISEASE IN PREGNANCY
It is so serious a thing for a woman with valvular lesion or other
cardiac defect to become pregnant that no young woman with heart
disease should be allowed to marry. Perhaps every normal heart
during pregnancy hypertrophies somewhat to do the extra work thrown
on it, but it may easily become weakened and show serious
disturbance as its work grows harder and the distention of the
abdomen and the upward pressure on the diaphragm increase. This
pressure perhaps generally displaces the apex of the heart to the
left and causes the heart to lie a little more horizontal. If the
patient is normal, there may be a gradually increasing blood
pressure all through the months of pregnancy, and if the kidneys are
at all disturbed this pressure is increased, and there is, of
course, much increased resistance to the circulation during labor.
The better the heart acts, the less likely are edemas of the legs
during pregnancy. It is thus readily seen that pregnancy is a
serious thing for a damaged heart. The reserve strength of the heart
muscle, as has been previously stated, is much less in valvular
compensation than that of the normal heart, and this reserve force
is easily overcome by the pregnancy, and loss of compensation occurs
with all of its usual symptoms.
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