HEALTH NOTES.

Hauraki Plains Gazette, Volume XXXX, Issue 5372, 9 January 1929, Page 3

HEALTH NOTES.

THE HEW. FUNCTION AND SYMPTOM. What is a diseased heart ? Many people are terrified when their doctors, noting an abnormal sound in a routine examination, tqlj them that they have a weak heart. Very often t'hes,e hearts arq perfectly healthy, and the abnormal sounds have no significance. On the other haniji, some people have diseased hearts who do not know it, although probably there have been symptoms which have been disregarded or misinterpreted. If, suddenly, an extra strain is thrown on the diseased heat, it becomes permanently incapacitated, or it ceases to act, and death occurs. The demarcation between health and disease is not sharply defined'. The heart is qxtremely adaptable. It may so adjust itself to slight disease or' abnormality as to do the same amount of work as a healthy heart. There may be no apparent disability and 1 there; will probably be no, diminution in the expectation of life. The hqart is a hollow muscle which pumps the blood through the body to supply nutriment to every c.ell and to, remove waste products. The heart muscle itself has it's., own blood veslf the circulation in the coronary artery ceases by being blocked by a c.lot of blood, for instance, the heart muscle cannot be properly nourished and' it soon ceases to work. Thus, sudden death results. To facilitate its action by minimising friction, the heart is lined with a Layqr of very smooth cells, as also are the blood vessels. The heart is enclosed: by a . bag, the pericardium. The outside of the Ihejart and the inside layer. of the pericardium are covered: similarly with a smooth layer of. cells. In the healthy adult the size and shape of the .heart is approximately that of the loosely shut fist, and the rate of pulse is about 72 beats a minute. In infancy the rate is nearly double, and in old age often Being a: muscular organ, the heart, like other muscles, will grow larger (or. hypertrophy) with extra work, andl grow smaller (or atrophy) if not used as much. The size of tbq heart, more-t over, varies with, the size of the in-> dividual. A blacksmith’s heart will be larger, than that of a clepk who leads a sedentary life. Because the heart is adaptable, cases of acute dilation by reason of violent muscular effort are not nearly as common as is imagined. Actual rupture, or tearing of the heart, is, extremely rare, but it is occasionally met with. LEAKING VALVES'. Disease germs carried by.the; blood stream must pass through the heart. If tlhey attack the lining of the heart inflammation is set up, which causes a roughening of the heart walls, and, worse; still, of. tihe valves. The roughened valves do hot fit as accurately a'§

before, and when fibrous changes take place as the result of chronic inflammation the flexibility of the heart valves is lost. Either the valve opening is reduced in size or the valve does not close properly. Often both faults occur together. A smaller valve opening causes the heart to. ®jnlarge or hypertrophy, to force the blood more strongly tnrough 'the stricture. The leaking valve also causes it to enlarge, because it c,an never properly empty itself. Each time it relaxes blood regurgitates' back from the artery, thus causing dilation from back pressure. Such a heart cannot respond to the; needs of the body as d normal heart. If the damage to the lining of the heart and valves is slight, the extra hypertrophy of the muscle will be sufficient to compensate for it. Such a heart is /practib cally as good as normal. Should the damage be s ( o great that the best efforts of the heart will supply only sufficient blood for the minimum needs of the tissue; cells, extra exertion cannot be allowed for. The owner of such a heart is incapacitated fr,om any movement. Even breathing is sometimes an effort. Most cases of valvular .trouble lie between these two extremes. The heart is not capable of any Sjiidden strain, hence the patient carefully avoids overloading it by unnecessary exertibn. If the damage is severe, all exercise will (have to be abandoned. Nothing more than easy walks may be indulged in. If the damage is not so severe, the avoidance of strenuous exertion may be sufficient. The heart’s work may be increased by the necessity of. forcing the blood through: ob-

Stacies other than defective valves. Any clogging of the kidney filter, for instance, as in' Bright’s disease, will throw extra strain on the heart muscle. So does disease of tlhe lilver, or widespread disease of the lungs, such as pneumonia, under which the heart frequently gives way. The heart can also be hampered) by any roughening of the outer oil pericardial lining, or by effusion between the two layer!?, in the sattfe way as th® lungs are hampered by pleurisy, the pleura and pericarium being, similar structures.

All forms of heart disease inay arise from the one cause. They may often be found in one heart, though probably at different stages. A common sequence is acute rheumatism or. rheumatic, fever, followed by endocarditis, with roughened l valves and dilation of the heart. Later this becomes chronic endocarditis, with; narrowed and leaking valves, and a hypertrophied and dilated heart, still later, the conductivity of the heart muscle to normal stimuli fs upset, and an irregular and hopelessly deranged l heart action is the final result. Rheumatism is. the most common cause of heart disease. Some authorities attribute 75 per cent, of the damaged hearts to this disease- Other common causes are influenza, scarletina, and venereal disease ; and, to a lesser extent, alcohol, nicotine, and l excessive physical toil and' hardship. The soldier’s heart, or disordered action of the heart, was frequently the result of severe physical strain, disordered nervous system, and 1 excessive cigarette smoking. The smoker’s heart is well known to most medical men.