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He went out, to give it to the Sergeant, and, when he came back, found her seated in the big chair by the fire. "The present little attack is nothing, Mr. Beaumaroy," she said. "Stomachic with a little fever; if he takes what I've prescribed, he ought to be all right in the morning. But I suppose you know that there is valvular disease quite definite? Didn't Dr. Irechester tell you?"
If it occurs later in life it generally is associated with aortic narrowing, and is a part of the general endarteritis and perhaps atheroma of the aorta. Sometimes it is caused by strenuous exertion apparently rupturing the valve. This form of valvular disease frequently ends in sudden death. On the other hand, it is astonishing how active a person may be with this really terrible cardiac defect.
He had noticed that her lips were rather blue, and had called in Dr. Ed. It was valvular heart disease. Anna was not to be told, or Sidney. It was Harriet's ruling. "Sidney can't help any," said Harriet, "and for Heaven's sake let her have her chance. Anna may live for years. You know her as well as I do. If you tell her anything at all, she'll have Sidney here, waiting on her hand and foot."
She could bring on a valvular heart attack by just sitting still and holding her breath, as Jean and his mother had long since found out; and she always treated them to one when things weren't going as she liked.
Frequently more than one murmur and more than one lesion in a heart are present. Often one murmur denotes a permanent lesion, and another may be one that will become corrected when compensation is improved. Before discussing the treatment of broken compensation in general, it may be well to describe briefly the differences in the symptoms and treatment of the various valvular lesions.
But he has been dying for some time, and what he told me in Paris was no lie. I explained his exact position to you quite recently, on the day you visited my niece at her studio. He had a serious valvular disease of the heart, he might, as the doctors said, have lived, at the utmost, two years but the excitement of recent events has evidently proved too much for him.
At first we used to shut our eyes and run the horse past this graveyard, and if the horse stepped on a twig my heart would give a violent movement, and it is a wonder that I haven't some valvular disease of that organ. But soon this running of the horse became monotonous, and after a while all fears of graveyards absolutely disappeared from my system.
When this has happened, the heart is in the condition of a pump which will not hold water, because the leather valve in its bucket is broken or warped; and we say that the patient has valvular or organic heart disease.
A patient with coronary disease should certainly not go to any great altitude, while patients with compensated valvular lesions, he found, were not injured by ordinary heights. He found that altitude seemed to decrease high systolic and diastolic pressures, while it even elevated those which were below normal, and caused these patients to feel better.
Chronic myocarditis may develop on an acute myocarditis, but is generally a slowly progressive chronic process from the beginning; it occurs mostly in persons past middle life, and as a rule is not primarily associated with rheumatism or valvular disease of the heart.
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