Part 21

Inflammation of the pericardium (heart bag) is often associated with pneumonia and pleurisy, rheumatism, and other constitutional diseases, or with an injury. It also occurs as an independent affection, owing to causes similar to those of other chest affections, as exposure to cold or dampness and changes of the weather.

Symptoms.--It may be ushered in with a chill, followed by fever, of more or less severity; the animal stands still and dull, with head hanging low, and anxiety expressed in its countenance. The pulse may be large, perhaps hard; there is also a venous pulse. The hand against the chest will feel the beating of the heart, which is often irregular, sometimes violent, and in other instances weak, depending in part upon the quantity of fluid that has transuded into the pericardial sac. The legs are cold, the breathing quickened and usually abdominal; if the left side of the chest is pressed on or struck, the animal evinces pain. There may be spasms of the muscles in the region of the breast, neck, or hind legs. After a variable time swelling may also appear in the legs and under the chest and brisket.

In those animals in which the heart sounds may be heard somewhat distinctly, the ear applied against the chest will detect a to-and-fro friction sound, corresponding to the beats of the heart. This sound is produced by the rubbing of the internal surface of the heart bag against the external surface of the heart. During the first stages of the inflammation these surfaces are dry, and the rubbing of one against the other during the contraction and relaxation of the heart produces this sound. The dry stage is followed by the exudation of fluid into the heart sac, and the friction is not heard until the fluid is absorbed sufficiently to allow the surfaces to come in contact again. But during the time the friction sound is lost a sound which has been called a "churning noise" may take its place.

The friction sound of pericarditis can not be mistaken for the friction sound of pleurisy if the examination is a careful one, because in the heart affection the sound is made in connection with the heart beats, while in the pleuritic affection the sound is synchronous with each respiration or breath of air taken in and expelled from the lungs.

Treatment.--When pericarditis is complicated with rheumatism or other diseases the latter must be treated as directed in the description of them. The animal must be kept in a quiet, comfortable place, where it will be free from excitement. Warm clothing should be applied to the body, and the legs should be hand-rubbed until the circulation in them is reestablished, and then they should be snugly bandaged. The food should be nutritive and in moderate quantity. Bleeding should not be performed unless the case is in the hands of an expert.

At the beginning give as a purgative Epsom salt--1 pound to an average-sized cow--dissolved in about a quart of warm water and administered as a drench. When there is much pain 2 ounces of laudanum, diluted with a pint of water, may be given every three hours until the animal is better. Do not give the laudanum unless demanded by the severity of the pain, as it tends to constipate. Give one-half ounce of nitrate of potassium (saltpeter), dissolved in drinking water, four or five times a day. After the attack has abated mustard mixed with water may be rubbed well over the left side of the chest to stimulate the absorption of the fluid within the pericardium. The other medicines may be discontinued and the following administered: Sulphate of iron, 2 ounces; powdered gentian, 6 ounces; mix and make 8 powders. Give one powder every day at noon, mixed with feed, if the animal will eat it, or shaken up with water in a bottle as a drench. Also the following: Iodid of potassium, 2 ounces; nitrate of potassium, 8 ounces; mix and make 16 powders. Give one in drinking water or in drench every morning and evening. The last two prescriptions may be continued for several weeks if necessary.

In extreme cases tapping the pericardium with a trocar and cannula to draw off the fluid is resorted to, but the operation requires exact anatomical knowledge.

After death from pericarditis there is always more or less fluid found in the pericardium; the surfaces are rough and covered with a yellow-colored exudate. There are also in many cases adhesions to a greater or less extent between the heart and pericardium.

MYOCARDITIS.

Inflammation of the muscular structure of the heart occurs in limited, circumscribed areas, as evidenced by post-mortem examination, and it is probably always somewhat involved in connection with pericarditis and endocarditis. It may readily be inferred that if the whole organ were inflamed death would ensue immediately. Usually myocarditis results from the preexistence of blood poisoning or of some infectious febrile disease.

Symptoms.--The chief symptoms are those of heart weakness. The heart beat is fast, weak, and often irregular. Respiration is difficult and rapid. There is great general weakness and depression. Death comes suddenly.

Treatment.--Treatment consists in supporting the animal by the use of stimulants, such as ammonia, coffee, digitalis, camphor, etc. Complete quiet must be provided, and the general care should be as in pericarditis.

ENDOCARDITIS.

When the membrane which lines the cavities of the heart--the endocardium-- suffers inflammation, the disease is called endocarditis. The cause is another disease, during which substances that irritate the lining of the heart are produced and admitted into the circulation. These substances are usually living organisms, or it is possible that in some cases they are chemical irritants. Endocarditis occurs as a complication of or sequel to pneumonia, blood poisoning, inflammation of the womb, rheumatism, or severe wounds or abscesses. The symptoms are much the same as those of pericarditis, and it is difficult to discriminate between the two affections. There is a jugular pulse, the legs may become dropsical, and there is a tendency to faint if the head is elevated suddenly. The bellowslike sound is more distinct than it is in pericarditis. It is the most fatal of heart diseases, because of the liability of the formation of clots, which may adhere to the valves, change in the structure of the valves, and often a complication with an abnormal condition of the blood. Clots may be formed in the heart, and, being carried to other parts, prove fatal by interrupting the circulation in some vital organ.

Treatment similar to that advised for myocarditis may be followed in this disease.

VALVES OF THE HEART.

The valves are subject to abnormal growths and structural changes in chronic endocarditis or as a result of acute endocarditis. Sometimes valves are torn by sudden, extreme muscular effort or a congenital abnormality. Cases are also reported in which they have been found ruptured.

Symptoms.--The general symptoms are those of heart weakness, accompanied with edema and congestion of the lungs.

Treatment.--Relief is sometimes afforded, but usually only temporarily, by the use of stimulants, especially digitalis.

RUPTURE OF THE HEART.

Sudden effort, blows, or disease may lead to rupture of the heart of the ox. The first cause does not operate so often in cattle as in horses. Tuberculosis or ulceration from other causes, such as a foreign body, is the most common source of this accident. Rupture is shown by sudden fainting, followed very shortly by death.

HYPERTROPHY AND DILATATION OF THE HEART.

This is an enlargement of the heart, and may consist of the thickening of the walls alone, or at the same time the cavities may be either enlarged or diminished. Dilatation of the cavities has been noticed as existing independently of thickened walls. In hypertrophy the sounds of the heart are loud and pronounced, may be heard on both sides of the chest distinctly, and palpitation occurs to a greater or less extent. Fortunately both conditions are very rare in cattle.

ATROPHY.

Atrophy is the technical term for wasting of the muscular tissue. Atrophy of the heart is very rare among cattle, and is usually a result of other diseases.

FATTY DEGENERATION OF THE HEART.

This condition of the heart is met with in some very fat cattle, but it must be understood that the accumulation of fat around the heart is not referred to by this designation. In fatty degeneration the elements of the muscular tissue are replaced by fatty or oily granules. The muscle becomes weak, the heart contractions are insufficient, and heart weakness is shown by general weakness, shortness of breath, and weak, rapid pulse.

CYANOSIS.