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The Soldier's Heart and the Effort Syndrome
The Soldier's Heart and the Effort Syndrome Author:Thomas Lewis Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: Chapter II. THE " EFFORT SYNDROME." ITS SYMPTOMS AND SIGNS, CONTRASTED WITH THOSE OF HEART DISEASE. Breathlessness. In the following pages I purpose ... more »to describe the symptoms and signs which constitute the " effort syndrome," dealing with each symptom and sign also from the standpoint of differentiating real and supposed heart maladies. Breathlessness is an almost universal complaint amongst patients admitted to hospital under the Army diagnoses of "D.A.H." and "V.D.H.," though it is variable both in its degree and in its type. The patient may be breathless when at absolute rest ; this is comparatively rare. There may be slight breathlessness when the patient is walking quietly about the wards ; this is not uncommon. Lastly, breathless- ness is experienced on exertion ; this is almost universal in the patients on admission. In the last groups the reserve is diminished ; in the first group it is abolished. The causes of breathlessness amongst our soldier patients as a body are several and it is well to distinguish certain clinical types. 1. Breathlessness which is due to deficient aeration of the blood is accompanied by cyanosis, slight, moderate or deep, according to the urgency of the dyspnoea. Theexcursion of the chest is greater and is also more frequent than normal; it is often irregular in rhythm. This type of breathlessness is rare in our patients ; when it occurs, serious structural changes in the heart are to be found and the veins of the neck are swollen and the liver is engorged. It is said to be produced by loss of alveolar space ; the capillaries of the lungs are engorged and encroach upon the air space (Peabody). The medical officer should ponder on the clinical relation of breathlessness and cyanosis. When a patient rests in bed and has no cause f...« less