Rheumatic Endocarditis

The patient complained of a general malaise, early fatigue on exertion, cardiac discomfort and palpitation.

The physician found him to have been having an increase of body temperature to a subfebrile level for a prolonged period of time. The patient stated that the onset of the disease had been preceded by tonsillitis. The patient's pulse rate had become irregular and accelerated on physical exertion.

The blood analysis revealed moderate leucocytosis and an elevated ESR. The electrocardiogram showed the changes in the most important readings. On

percussion the doctor determined the heart to be slightly enlarged. These find-ings of the physical examination were confirmed by the X-ray examination.

While listening to the patient's heart the doctor found a soft systolic murmur to be heard at the heart apex. These symptoms were accompanied by diastole murmur heard at the apex and base of the heart. The doctor estimated the murmurs to be varying in their intensity and duration. It was evidence of an inflammatory process in the valves. The doctor determined the organic changes in the mitral, aortic and tricuspid valves to be clearly marked.

The physician considered the patient to be ill with rheumatic endocarditis and insisted on his following a strict bed regimen at the in-patient department

Cardiosurgery

Within the last 20 years a new branch of surgery - cardiosurgery has been developing successfully in our country. The beginning of its development was marked by the fist operation on the heart, performed by A.N.Bakulev. It is due to the such prominent Soviet surgeons as Vishnevsky, Mashalkin, Petrovsky and others that great progress has been achieved in cardiosurgery. The lives of many thousands of people suffering from cardiac diseases and those of coronary vessels have been already saved.

The operation on the heart are performed to eliminate the existing heart defects, congenital or developed, and to restores the normal function of the heart.

The operation on the heart is presided by various examinations, which enable the surgeon to make a correct diagnosis. The most important ones are listening to the heart, its x-ray examinations, electrocardiograms, the revealing of heart murmurs, and clinical and biochemical blood analyses. Only having made an exact diagnosis and having come to the conclusion that the therapeutic measures have been ineffective the surgeon can perform the operation on the heart.

The operations on the heart are very difficult because of the intricate anatomical structure of the heart and because the heart is constantly contracts.

Some operations are performed on the contracting heart, but such operations give the surgeon only a very short period of time for his surgical manipulations. Besides in such cases there is always the possibility of the impairment of cardiac function such as heart failure fibrillation and others. In the presence of these impairments complete or partial arrest of blood circulation develops.

Such intervals of blood circulation result in the damage to some organs, for example, the brain can live without blood supply only four-five minutes: If the interval is longer the brain cells die.

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