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A very plausible one is, that the cardiac palsy is caused by energetic and persistent excitement of the inhibitory cardiac nerves. Strand is accredited with saying that agony of the mind produces rupture of the heart. It is quite common to hear the expression, "Died of a broken heart;" and, strange to say, in some cases postmortem examination has proved the actual truth of the saying.
Caffein: This should not be given or allowed, even in the form of tea or coffee, to patients who have valvular lesions with perfect compensation, as it is a nervous and cardiac stimulant and may cause a heart to become irritable. It raises the blood pressure slightly, acts as a diuretic, and hence is often of great value when used medicinally. It should be ranked as a stimulotonic to the heart.
Each occurrence of broken compensation in valvular disease causes another attack of cardiac weakness to occur with less excuse than before, and several serious attacks of broken compensation mean before long the loss of the heart muscle's ability to recover, so that permanent dilatation occurs.
The more and more frequently repeated statements that the operation was successfully performed but that the patient died of shock, and that the typhoid fever and the pneumonia were being successfully combated, but that the patient died of heart failure, together with the increase in arteriosclerosis, cardiac disturbances and renal disease, emphatically present the necessity of more carefully studying the circulation.
Nor did it keep the cardiac region of the Arethusa of the Dream from fluttering in an altogether delightful way. Ross took Arethusa out to the Country Club for a round of golf the next afternoon, and as it was the first and only time she had ever spied a golf club, it is not at all difficult to imagine what sort of game she played.
Flatulence from any cause must be avoided. It dilates the stomach and intestines, causing them to press on the diaphragm, so that the heart and respiration are interfered with. Also, an increased abdominal pressure, especially if there is any edema or dropsy, is bad for the circulation. A distended, tense abdomen is serious in cardiac failure.
Such an operation would be indicated when the apex is fixed so that there is a constant sensation of hugging of the heart at the fourth and fifth ribs, with paroxysms of pain and cardiac weakness. While the myocardium is the most important muscle structure of the body, it has but recently been studied carefully or well understood clinically or pathologically.
It opens wide, child-wide eyes to see, to see. But it cannot see. It is puzzled, it wrinkles its face. But when the mother puts her face quite near, and laughs and coos, then the baby trembles with an ecstasy of love. The glamour, the wonder, the treasure beyond. The great uplift of rapture. All this surges from that first center of the breast, the sun of the breast, the cardiac plexus.
Also, it is of great value to send a patient to a resort where the climate is good and the scenery is lovely and soothing. No disease, perhaps, needs cheerfulness and pleasantness and lack of anxiety, or frets more than does cardiac weakness. A tuberculous patient may sit on a mountain top with snow blowing about him, and recover; a heart patient must have sunshine and comfort.
Comparison of the findings after these two injections will determine which factor, vagal or cardiac tissue, is the greater in the condition present. The patients with a large cardiac factor are the ones who may be more improved by the digitalis treatment than those in whom the fibrillation is caused by vagus disturbance. The prognosis depends on the condition of the myocardium of the vagus.
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