CHAPTER XIV 



EFFECTS ON THE HEART AND BLOOD VESSELS 



The cardiac, musculature, like the skeletal, undergoes atrophy and degenera- 

 tion during starvation, resulting ultimately in cardiac weakness and circulatory 

 disturbances. During partial inanition, the human heart may be either 

 atrophied (in malnutritional edema, pellagra or thirst) or hypertrophied (in 

 rickets, beriberi or scurvy). The blood vessels are also affected, especially in 

 edema and scurvy. After a brief summary, the effects of inanition upon the 

 heart will be considered under (.4) total inanition and (B) partial inanition. 

 Finally (C) the effects of inanition upon the blood vessels will be discussed. 



Summary of Effects on Heart and Blood Vessels 



In human adults the loss in the weight of the heart during total inanition 

 appears variable, but is roughly proportional to that of the skeletal muscula- 

 ture and the body as a whole. As a rule, this applies likewise to atrophic 

 human infants. In adult animals, the same rule holds, with variations; but 

 in the guinea pig, at least, the cardiac loss appears relatively greater toward 

 the end of starvation than at earlier periods. In young animals, the heart 

 appears relatively more resistant during underfeeding, and in the young rat 

 it may even increase in weight while the body weight is stationary. 



The structural changes in the heart during total inanition (or on water only) 

 involve a variable degree of atrophy and ultimate degeneration of the cardiac 

 muscle. Among human adults during inanition, brown or pigmentary atrophy 

 of the cardiac muscle fibers is characteristic, with more or less vacuolation and 

 nuclear proliferation (sometimes degeneration). The myofibrillae become less 

 distinct in cross striation, and fatty degeneration may occur to a variable extent. 

 The pericardial and interstitial fat disappears, and the interstitial spaces 

 between the cardiac muscle fibers become more extensive. In atrophic human 

 infants, the changes appear somewhat similar, but less extensive and more 

 variable. Pigmentation apparently does not occur as in adults. The myo- 

 cardium may appear nearly normal, and in some cases the cardiac muscle fibers 

 may even appear hypertrophied. There may also be a variable degree of 

 interstitial fibrosis. 



Among lower animals, both young and adult, the cardiac muscle during 

 total inanition likewise undergoes a variable degree of atrophy and degenera- 

 tion. During abundant nutrition there may be a considerable amount of fat 

 stored as small droplets within the cardiac muscle fibers, especially in hiber- 



