Структура и заболевания сердца
at any age. It is the result of rheumatic fever, a combination
of a streptococcal infection and an allergic sensitivity to
streptococcal germs. It is responsible for most heart disease in
individuals under the age of 20.
Early
indications of rheumatic fever may be a state of fatigue, poor
appetite, failure to gain weight, paleness, and anemia.
It
is estimated that 50 percent of those who are diagnosed in adulthood
as having chronic rheumatic heart disease never realized they had
experienced attacks of rheumatic fever as children. The disease
causes an inflammation of the heart muscles and heart valves, and
scars the valves so that they do not perform normally. The damage may
prevent the valves from opening or closing properly. Rheumatic fever
is controlled by regular doses of penicillin and sulfa drugs,
particularly in adolescents and young adults.
Bacterial
Endocarditis
This
is a bacterial infection of the lining of the heart (endocardium)
and the valves which may follow rheumatic fever and also may occur in
persons with congenital defects of the heart. Bacteria, usually of
the streptococcus family, can enter the blood stream after operations
on the mouth, throat, nose, or intestines. If the microbes reach
defective heart valves, they can grow on them and cause a dangerous
illness. That is why persons with a history of rheumatic fever or
those with congenital heart abnormalities may be given penicillin or
sulfa drugs before undergoing certain operations or tooth
extractions.
There
are two forms of the disease, acute
and subacute,
with the subacute form or more common. The acute type strikes the
person suddenly and can be fatal within a few days if immediate
treatment is not given. Treatment includes bed rest and antibiotics.
Coronary
Insufficiency.
Coronary
insufficiency is a term applied to heart difficulties in which the
blood flow in the coronary arteries which nourish the heart muscle
itself may be decreaced.Atherosclerosis
,a
common form of hardening of the arteries, may produce this condition
by thickening or narrowing the walls of the coronary arteries.When
the arteries are narrowed, less blood and less oxygen are carried to
the heart musclemen.One form of such insufficiency is ANGINA
PECTORIS, in which the coronary arteries temporarily do not provide
the necessary blood to the heart muscle. The amount of blood to the
heart muscle may be adequate for periods of rest or mild activity.
Under conditions of emotional stress or increased physical exertion,
the supply may be insufficient for the added work of the heart, and
pain will result. The characteristic pain has been described as
crushing or viselike and located near the left breast. The pain may
fan out to the left arm and left fingers. Treatment consists of rest,
nitroglycerin
tablets
under the tongue, or inhalation of amylnitrite.
Heart
Failure
Heart
failure does not mean that the heart has stopped, but that its
pumping efficiency has lessened. Two types of failure can interfere
with normal circulation. In one, circulatory,
or forward,
failure, the heart is unable to pump enough oxygenated blood to the
tissues because a severe hemorrhage may cause the blood volume to
fall, or because the heart is not capable of supplying the tissues
with sufficient blood.
In
the second type of failure, known as cardiac
insufficiency
( backward,
or congestive,
failure), the heart muscle loses its normal vigorous beat and fails
to propel the blood out of the heart chambers as swiftly as it enters
them. As a consequence of the slowing of circulation, body fluids
collect in the tissues. The ankles may swell, and the individual may
be short of breath because of fluid in the lungs. There may be
various types of indigestion from congestion of the liver and other
abdominal organs. This type of heart failure may develop after a
severe heart attack or rheumatic fever, after a long period of
untreated high blood pressure, or in connection with a congenital
heart defect.
In
circulatory failure, the victim is pale and listless, and visible
veins sag. In cardiac insufficiency, the victim’s skin has a
bluish tinge, the jugular vein is swollen, and he breathes noisily.
The blueness stems from the fact that not enough oxygen is being
supplied to the arterial blood , and the tissues also lack sufficient
oxygen, while carbon dioxide mounts in the cells.
Treatment
for heart failure includes rest, a special diet with lowered salt
intake, medication(digitalis)
to strengthen heart action, and diuretic medicines to control the
excess of fluid.
Related
Disorders
Hardening
of the arteries and high blood pressure (hypertension)
are two of the most common forms of diseases affecting the heart, and
are found most frequently in the middle-aged or elderly person. The
conditions may be present separately, although they are frequently
associated. In the first, atherosclerosis, the walls of the arteries,
and particularly the internal lining called the intima,
may become roughened. Fatty deposits begin to collect. Fibrotic
materials, and sometimes calcium, coat these deposits, and help to
form what are known as atherosclerotic
plaques.
The damage spreads into the media,
the muscular-elastic part of the artery, and causes loss of
resiliency. These plaques fill the passageway, and gradually obstruct
the flow of the blood. As the arterial walls are narrowed, it becomes
more difficult for the blood to flow through the vessel.
Rise
in blood pressure may be caused by a variety of factors, including
emotional stress. In 90 percent of the cases, the specific cause
remains undiscovered. It is believed that high blood pressure helps
to speed the processes of hardening of the arteries and other blood
vessel diseases.
Hardening
of the arteries and high blood pressure are chiefly responsible for
STROKES (Known as celebrovascular
accidents),
which are caused by clogging or hemorrhaging of an artery in the
brain or in an artery in the neck leading to the brain. The walls of
an artery may have lost their smoothness and elasticity and collected
the deposits typical of hardening of the arteries, or the artery may
have been clogged by a blood clot from the heart. An area of the
brain to which the blood supply has been interrupted is injured, as a
result of which some muscular function controlled by the brain cells
may be temporarily or permanently lost.
Another
disease related to diseases of the heart and blood vessels is
NEPHRITIS (Bright’s disease), or inflammation of the kidneys,
which can cause high blood pressure. The heart works under the high
pressure handicap, as in other types of hypertension. An acute attack
of nephritis may so injure the capillaries, the tiniest blood
vessels, that fluid settles in the tissues, causing swelling in
various parts of the body.
Prevention
and Care
Guarding
against heart ailments involves a reasonable consideration for the
amount of work the heart is accustomed to doing. For example, a man
over 40 should remember that a burst of unusual physical work or
strenuous sport creates a strain on a heart that is accustomed only
to a sedentary life. Extra weight places an extra burden on the
heart. Fears of heart trouble can also be harmful. It is wise to have
regular medical check-ups, and take intelligent care of one’s
health, and to maintain a sensible approach to life between
examinations. This includes avoiding excessive use of tobacco,
following a well-balanced diet, taking regular exercise, and
maintaining a good balance between work, social life and rest.
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