A lady, about forty-five years of age, the mother of many children,
has been troubled during the course of the past year with violent
palpitations of the heart, and great difficulty of respiration,
especially on going up stairs. These complaints have lately increased,
so that she has kept in her chamber about two months. Her countenance
is florid; her eyes are clear and bright. She has dizziness,
especially on moving, without pain in her head. She had for some time,
a severe cough, which is now relieved. The dyspnoea is not yet very
distressing, except on using motion; it often occurs in the night, and
obliges her to rise and sit up in bed. The palpitations are very hard,
and so strong, that they may be perceived through her clothes; the
tumult in the thorax is indescribable. The functions of the abdominal
viscera are unimpaired. The pulse is hard, vibrating, irregular,
intermittent, very variable, corresponding with the motions of the
heart, and similar in each arm. There is not yet the slightest reason
to suspect any dropsical collection. The alternations of ease and
distress are very remarkable, but on the whole, the violence of the
symptoms increases rapidly.
There is no difficulty in discovering in this case an organic disease
of the heart, which probably consists in an enlargement and thickening
of the heart, and an ossification of the semilunar valves of the
aorta.