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Calcium glycerophosphate may be used, in powder form or in capsule, in doses of 0.30 gm. An exact prognosis of this inflammation is impossible. We do not know how far an acute myocarditis may progress and entire recovery take place; we do not know how slight a myocarditis may cause serious symptoms.
So common is this particular result of prolonged emotion that some one has said, "When the stocks go down in New York, diabetes goes up." Nephritis, also, may result from emotional stress, because of the strain put upon the kidneys by the unconsumed activating substances. The increased heart action and the presence of these activating secretions may cause myocarditis and heart degeneration.
If there are weakening perspirations, atropin should be given, especially as it is also a circulatory stimulant. Calcium in almost any form seems to be of value in the majority of heart conditions. It is a sedative to the nervous system, and is certainly indicated in acute myocarditis. Calcium lactate is perhaps the best salt to administer, in doses of 0.25 gm.
In other words, it may be weakened by myocarditis or fatty degeneration; or it may be a normal heart that has sustained a strain; or it may be a hypertrophied heart that has become weakened. Heart strain is of frequent occurrence.
If it is found that these increased exertions cause him to have pain or a more rapid heart than is excusable, even after persisting for a few days, the attempt to increase this reserve power of the heart should be abandoned. There is probably, at least at that particular time, considerable myocarditis, although the heart may eventually recuperate still more.
If the condition is developed from a myocarditis or from fatty degeneration of the heart, it may be impossible to cause the left ventricle to improve so much as to overcome this relative dilatation or relative insufficiency of the valve.
Large doses of alcohol in shock or collapse are contraindicated. Chronic overuse of alcohol may cause chronic myocarditis and fatty degeneration of the heart, with later weakening of the heart muscle and dilatation. In acute alcohol poisoning the pulse may become very rapid and weak, and the patient may die of heart failure. This is often seen in delirium tremens.
The acute myocarditis may develop some fatty degeneration, and with this softening and weakening of the heart muscle acute dilatation readily occurs, which may be a cause of sudden death, or, if less serious, may be the cause of prolonged disability, if the heart ever recovers its original size and strength. The symptoms are often indefinite, and the diagnosis of the condition hardly possible.
As referred to under the subject of myocarditis, many symptoms for which a patient consults his physician are indefinite and intangible, though due to cardiac weakness. If a patient with a damaged heart has a sudden dilatation, of course his symptoms are so serious that the physician is immediately summoned.
If the rapid heart continues until a myocarditis has developed and a weakening of the muscle fibers occurs, or dilatation is imminent or has actually occurred, operative interference is serious, and most patients under these conditions die after a complete operation, that is, the removal of from one half to two thirds of the thyroid.
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