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Updated: May 18, 2025
Prolonged bed rest must be continued, visitors must still be proscribed, long conversations must not be allowed, and the return to active mental and physical life must be most deliberate. No clinician could state the extent to which the valvular inflammation will improve or how much disability of the valves must be permanent.
These are nephritis, uncompensated valvular lesions of the heart, advanced tuberculosis, insanity, irremediable malignant tumors, hydatidiform mole, uncontrollable uterine hemorrhage, and acute hydramnios."
Such regurgitation may occur without valvular disease if for any reason the left ventricle becomes dilated sufficiently to cause the valve to be insufficient. Such a dilatation can generally be cured by rest and treatment. As with mitral stenosis, the most frequent causes are rheumatism and chorea, with the occasional other causes as previously enumerated.
While no physician likes to give an anesthetic to a patient who has valvular disease of the heart, and no surgeon cares to operate on such a patient unless operation is absolutely necessary, still in valvular disease with good compensation the prognosis of either ether or chloroform narcosis is good.
But when the valvular action is at rest under the stern finger of death, can all the marvellous appliances of this intensely and wonderfully mechanical age force one ruddy drop through those great tubes, or coax one solitary throb, where God has said "Be still"?
"Perhaps they should be put out of reach of poverty," later felt he "had caused death of wife and son on account of his expensive living." Autopsy: chronic internal hydrocephalus, cerebral arteriosclerosis. Brain weight 1180 grams. Coronary sclerosis with calcification throughout, aortic and pulmonary valvular calcification hypertrophy of heart. Cystitis.
DEAR SIR, Since I had the honour to see you in London I have had a sad loss: my poor uncle is no more. He died very suddenly after a hearty supper. One doctor says it was apoplexy, another valvular disease of the heart. He has left me his heir, after providing for his sister: no one had an idea that he had saved so much money. I am quite a rich man now.
Early in life probably the two sexes are equally affected with valvular disease, with perhaps a slight preponderance among females, because of their greater tendency to chorea. Females also show a greater frequency to mitral stenosis than do males.
On account of their important function in this operation the false vocal cords are called the 'breath-bands. Closure of the glottis by the inflation of the ventricles imposes no strain on the vocal cords. The theory of breath-control by "opposed muscular action" takes no cognizance of this operation. "Control of the breath in singing is effected by this automatic valvular action.
If there is no atheromatous condition of the coronary arteries, and arterial disease is not a cause of the valvular lesion, compensation may be broken by some sudden extra strain put on the heart, either muscular or by some acute sickness or a necessary anesthetic and operation.
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