Reversible forms of heart disease.

Abstract

For many years the diagnosis of heart disease connoted a life of invalidism with probable death by virtue of the affliction. In recent years, however, the marked advances in medical science have not only enabled the heart patient to live a more useful life but also have shown that many forms of heart disease are entirely curable. It is important to remember that a normal heart or one that is only slightly diseased may show symptoms that are solely the expression of some extracardiac disease, and that this extracardiac condition may manifest itself entirely or largely in the cardiovascular system. As a result, the cardiac symptoms may be so marked that they completely overshadow the underlying extracardiac disease. As a result the patient is often considered a cardiac invalid, whereas recognition of the effect of the extracardiac disease with treatment directed to the extracardiac condition usually brings about a reversibility in the cardiovascular symptoms. Failure on our part to recogni e that many extracardiac diseases are expressed clinically through the cardiovascular system has led to unnecessary invalidism and even death. In every cardiac patient we must constantly be aware of the possibility that the heart itself may not be actually diseased but that rather it is acting secondarily to other conditions in the body. It is only by recognizing these extracardiac factors before they produce structural changes in the heart muscle that the treatment of the extracardiac disease may be instituted sufficiently early for the patient to be cured. It is the purpose of this paper to point out in a general way some conditions that are manifested entirely or largely through the cardiovascular system, with the result that a normal or a previously damaged heart may be precipitated into actual cardiac failure. It is apparent that all of the diseases that may produce such changes cannot be listed in the space permitted, and under these circumstances only a brief mention will be made of the various illnesses that can affect the cardiovascular system. We are familiar with the symptoms presented by the markedly obese patient. He frequently complains of dyspnea, palpitation and precordial distress. Physical examination may often reveal an