The disease occurs generally in persons of advanced age, although those afflicted with true angina pectoris rarely attain a higher age than 55 or Co years. Active medical_ treatment is imperative. The discussion of the prevention and treatment of this affection will be found in the following paragraphs on General Rules for the Prevention and Treatment of Heart Diseases.
General Rules for the Prevention and Treatment of Heart-Diseases. The prevention of affections of the heart can be accomplished only by constantly guarding against their causes. Against many of these, however, medical science is at times powerless. The most important causes of valvular disorders are the in fectious diseases. Measles, scarlet fever, acute rheumatism, and diphtheria are frequently the precursors of heart-affec tions. Hence it is imperative to make all efforts possible to avoid these infections. Healthful living, fresh air, exercises, and gymnastics are essential in developing healthy bodies. Cleanliness of the body and of the dress, abstinence from alcoholic drinks, and protective vaccinations are also important aids. Convalescent individuals should rest in bed as long as possible, and should carefully avoid even the slightest exertion. In case any disturbance of the heart is experienced, the physician should at once he notified, no matter how insignificant the matter may seem.
Although physical exercises in general are beneficial to the development of the body, they may exert an injurious influence upon the heart if in dulged in to an immoderate extent. Sports which make excessive demands upon the activity of the heart should be entirely avoided unless the heart, by systematic training, has gradually been rendered equal to the extra exertion. Bicycling, rowing, mountain-climbing, etc., may exert a very deleterious influence upon the untrained heart, and may often cause permanent injury to the organ. Before indulging in any sport, it is therefore advisable to submit to a careful medical examination of the entire body.
Individuals suffering from affections of the heart should exercise great care also in the choice of a profession. Even slight valvular defects, which are compensated for by an increased activity of the heart, make it neces sary to choose professions which do not make excessive demands upon the mental and physical activities. A quiet, sedentary occupation, free from mental worry and physical exertions, is in order for such patients. Occu pations which require great strength, and, above all, a sound heart, should not be selected by individuals suffering from cardiac weakness The con stant and excessive use of drinks (coffee, tea, alcohol), and of tobacco may likewise give rise to harmful consequences. Habitual over-indulgence in the
pleasures of the table is also apt to exert an injurious influence upon the heart.
The treatment of diseases of the heart should in all cases be entrusted to an experienced physician. In addition to sufficient sleep and rest, it is of advantage to take moderate exercise in fresh air, with frequent deep in spirations, in order to promote the circulation of the blood. The living rooms, and especially the bedrooms, of persons suffering from heart-diseases should be large and airy, and must be ventilated several times a day. Equable climates at moderate elevations are preferable during summer, while southern maritime localities are to be recommended in winter. ,\s a rule, altitudes higher than 4,00o feet are not well stood by patients with weak hearts. The selection of a resort had best be left to the physician.
Cold ablutions with subsequent dry rubbings, and warm baths of about 86° to F. are often of much service. Great extremes of heat and cold are to he avoided. The regulation of the stools is of great importance, as the straining due to a constipated condition is very harmful to the heart. The daily evacuation of the bowels should be assisted by eating a great deal of vegetables and fruits, by oil or water enemas, or, if necessary, by mild laxatives.
Mental or sexual excitement often exerts an injurious influence upon patients with heart-disease, and should be avoided as much as possible. With reference to women who suffer from heart-affections, the question of marriage should be considered, as the possibility of pregnancy, and its consequent increased demands upon the heart, is an important issue. When the valvular defects are well compensated for, and have caused no dis turbances prior to marriage, the presence of a heart lesion is not necessarily a bar to marriage. The dangers are by no means as great as they are often assumed to be. But they may be called forth by repeated pregnancies. by mental emotions, and by physical over-exertions. In such cases a rational mode of living, a well-regulated diet, and careful medical supervision are absolutely essential. If albumin is present in the urine of a pregnant woman affected with heart-disease, it is advisable that she drink from one to one and a half quarts of milk daily during the first six months, and two quarts daily during the last three months, even if the affection does not cause her any uneasiness. The urine should be frequently examined by the attending physician.