DILATATION OF THE HEART.
Result of obstruction to circulation. In right ventricle usually. In auricle from narrow auriculo-ventricular opening. Pure dilatation from sudden extreme blood pressure as in inflammations of the lungs. In fat cattle from fatty obstructions around the heart and great vessels. Weakness of cardiac muscles in fatty degeneration, fevers, debility, etc. Symptoms, dyspnœa under slight exertion, unsteady walk, cold, dropsical limbs, venous pulse, pulse small, weak, irregular, intermittent, with palpitations. Treatment, in early stages arrest the causes, arsenic, digitalis, fatten for butcher.
Dilatation of the right cavities of the heart is one of the most common heart diseases of the horse. It is an almost constant condition in advanced broken wind, and is a frequent concomitant of hypertrophy and an occasional one of atrophy of the heart. Its usual direct cause is some obstacle to the free escape of blood from the cavity affected. Thus in broken wind the difficulty of the circulation through the lungs causes accumulation in the pulmonary artery and right ventricle of the heart, the walls of which are distended because of the unwonted internal pressure. When the dilatation of this ventricle reaches a certain stage the auriculo-ventricular opening is equally widened, the valves become insufficient to close it and the right auricle and venæ cavæ participate in turn in the internal pressure and dilatation. The right ventricle is more often affected than the left, because of the greater frequency of obstruction in the circulation through the lungs than in that through the general system, and because of the thinness of its walls which more readily give way under internal pressure. Dilatation may result from disease of the great arteries, from diminution of their calibre by the pressure of tumours, or by narrowing of their openings at the heart, whether as the result of diseased valves or other morbid condition. As affecting the auricles primarily its usual cause is narrowing of the auriculo-ventricular opening from some abnormal deposit. The extreme thinness of the walls of the auricles allows these to give way under internal pressure even much more readily than the right ventricle.
The causes it will be seen are similar to those inducing hypertrophy, and hence the frequent coexistence of the two. Pure dilatation occurs especially when internal pressure takes place suddenly and to excess, and while the nutritive functions are to a great extent in abeyance. Such conditions are found in acute inflammations of the respiratory organs, or of the inner or outer membranes of the heart, and the rapid deposit in the lungs of tubercles or other abnormal material.
Dilatation of the right side of the heart is a common complaint in overfed cattle, and is apparently due to the diminished power of resistance in the walls of the heart, the muscular substance of which is partly replaced by fatty granules, and to the obstruction offered to the circulation by the extraordinary accumulation of fat around the base of the heart and the commencement of the large blood vessels. Though a diseased condition this rarely shortens life or interferes with the uses to which cattle are put.
The heart walls are similarly weakened and yield more readily to the internal blood pressure in endocarditis, myocarditis, pericarditis, high fever, infectious diseases, poisonings, anæmia, and debilitating diseases generally. Debility and incapacity to resist the blood pressure is the essential prerequisite to dilatation.
The symptoms which have been already enumerated in the table given under the head of hypertrophy are mainly these: Loss of appetite, spirit and endurance; faintness and difficulty of breathing on the slightest exertion; habitual coldness with a tendency to dropsy of the extremities; loss of control over the extremities when walked or trotted far; venous pulsation in the jugulars; heart’s impulse weak and undulatory or tremulous, or under exertion tumultuous or palpitating; murmur often present with the first sound; the first or more commonly the second sound may be doubled; pulse small, weak, irregular, and often intermittent, and frequently livid spots in the nasal mucous membrane. Paroxysms of unsteady gait from irregular circulation in the brain is frequent, and Dyer asserts that he has repeatedly seen blindness as a result of this condition.
In treatment the main purpose should be to put a stop to the cause of the disease before it has been developed to a dangerous extent. When the malady is manifested by the symptoms above enumerated the subject is rendered permanently unfit for service and will probably die suddenly under some slight exertion. Fattening animals in a condition of quietude will often lay on flesh for an indefinite length of time notwithstanding that the heart is considerably dilated. (See note on digitalis, strophanthus and arsenious acid in dilated heart, under the head of hypertrophy). To relieve the asthmatic attacks attending on an overtaxed heart Zuill strongly recommends the combination of iodide of potassium, digitalis, nux vomica and coca. But heart tonics are often much more affective after the bowels and portal system have been unloaded by a laxative.