1074 Chronic Myocarditis, 



A disease described by some Hungarian veterinarians (Sehleiffer, 

 Viasz, Horvath, Laszlo) as a sequel of foot and mouth disease is prob- 

 ably also based upon a chronic myocarditis which has developed out of 

 the acute inflammation. The most striking morbid symptoms are 

 dyspnea, attacks of asphyxia during motion, delayed change of the hair 

 coat, bad nutrition and diminished milk secretion. 



Anatomical Changes. The heart muscle is more solid, 

 either throughout or, more frequently, in portions of various 

 extension, and contains grayish-white spots or streaks (scars). 

 (In extensive degeneration of the cardiac muscular fibers, the 

 heart muscle may, however, become softer, even before the 

 occurrence of an active tissue atrophy.) More extensive scars 

 are bulged outward through the action of the blood pressure 

 (aneurysma cordis chronicum fibrosum). The heart is en- 

 larged in the case of extensive disease, both owing to a thick- 

 ening of its walls and because of a dilatation of the cavities. 



Symptoms. Smaller scars in the heart muscle sometimes 

 do not cause any morbid symptoms. Since, however, larger 

 portions of the heart are usually affected, manifestations of 

 heart weakness nevertheless appear sooner or later. A partial 

 atrophy of the muscular fibers may, in certain cases, be com- 

 pensated by the increased functioning of the unaffected fibers, 

 but this compensation lasts only for a time and finally the 

 symptoms of heart weakness appear in such cases also. 



In the initial stage of the disease, which occasionally lasts 

 a long time, the cardiac insufficiency becomes evident only after 

 severe exertion or excitement. The pulse is much increased, 

 usually arhythmical and feeble. The heart beat is irregular 

 and bounding; the systolic heart sound loud and high. The 

 veins are filled strongly. There is vertigo, staggering gait, 

 rapid fatigue, severe dyspnea, occasionally collapse. In the 

 further course these symptoms become manifest even at rest, 

 after a dilatation of the heart has been added in the meanwhile, 

 owing to which endocardial sounds may be manifest. After 

 variable periods of time serous fluid accumulates in the serous 

 cavities and cutaneous edemata develop. 



Course. The condition of the animals often varies con- 

 siderably, especially under the influence of external conditions. 

 In some cases, especially after over-exertion, death may occur 

 suddenly even before the condition has become very serious. 

 On the other hand, the disease may be recognized in animals 

 which are saved from excessive exercise only on the occurrence 

 of symptoms of stasis (chronic bronchial catarrh, dropsy, 

 gastro-enteric catarrh, etc.). 



Diagnosis. Chronic myocarditis may be recognized only 

 then when the development of the morbid condition out of an 

 acute disease of the heart or of its linings can be followed 



