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Updated: May 18, 2025
The doorbell buzzed. "That's the detective," said Dr. Surtaine to Hal. "Stay here." He wormed himself painfully into an overcoat which concealed his scarified shoulder, and went out. In a few moments he and the officer reappeared. The latter glanced at the body. "Heart disease, you say?" he asked. "Yes: valvular lesion." "Better 'phone the coroner's office, eh?" "Not necessary.
This may occur in a previous rheumatic heart and in a heart which has suffered endocarditis and has valvular lesions, or it may occur from valvular strain or heart strain from various causes; it is typically a part of the arteriosclerotic process of age, and is then mostly manifested at the aortic valve.
Though he pretended to be sympathetic, he was visibly overjoyed at our misfortune, which turned the tables upon us for once, and his suggestions were enough to wreck the valvular system of a motor-car; not to mention the nervous system of a distracted chauffeur. "Perhaps the petrol's dead," said Mr. Barrymore, paying no heed to the Prince's ideas.
It has been suggested that, though lime may be of advantage in heart weakness, as will be stated later, if the blood is overfull of calcium ions the valvular irritations may more readily have deposits of calcium, in other words, become calcareous, and therefore cause more obstruction.
The middle coat contracts and retracts, and the internal, because of its elasticity, curls up in the interior of the vessel, forming a valvular obstruction to the blood-flow. In most cases this results in the formation of a thrombus which occludes the vessel. In some cases the blood-pressure gradually distends the injured segment of the vessel wall and leads to the formation of an aneurysm.
Tricuspid stenosis, pulmonary stenosis and pulmonary insufficiency are rare, and are probably nearly always congenital. The diagnosis as to whether the murmurs heard in the heart are hemic, functional, accidental, or indicative of valvular lesions would be without the scope of this book. It is always presumed that a correct diagnosis has been made, or at least a presumptively correct diagnosis.
By this artificial tightness of the skin, the arterial pulsations act with double their usual power in promoting the ascending current of the fluid in the valvular lymphatics. Internally the absorption from ulcers should be promoted first by evacuation, then by opium, bark, mercury, steel.
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.
Sometimes one good-sized dose of digitalis may be of benefit, but it is often disappointing, and unless there is a valvular lesion with signs of broken compensation, it is rarely indicated. It should also be remembered that, if the patient is receiving digitalis in good dosage for broken compensation, tachycardia may be caused by an overaction of the digitalis.
Again in another work he says, the genera of the Connaraceæ "differ in having one or more ovaria, in the existence or absence of albumen, in the imbricate or valvular æstivation. Any one of these characters singly is frequently of more than generic importance, though here even when all taken together they appear insufficient to separate Cnestis from Connarus."
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