. Medical diagnosis for the student and practitioner. rom temporary overstrain and dilatationprovided that relative rest is secured. Otherwise, many, rather than a smallminority, of college athletes would carry damaged or even crippled hearts.* * The heart of the perfectly trained robustly built athlete will actually diminish in sizewith quickened rhythm under strenuous exercise even if sustained during considerableperiods, but the author has seen many congenitally asthenic or badly trained young ath-letes retired with badly dilated and extremely irritable hearts. Permanent damage is notuncomm
. Medical diagnosis for the student and practitioner. rom temporary overstrain and dilatationprovided that relative rest is secured. Otherwise, many, rather than a smallminority, of college athletes would carry damaged or even crippled hearts.* * The heart of the perfectly trained robustly built athlete will actually diminish in sizewith quickened rhythm under strenuous exercise even if sustained during considerableperiods, but the author has seen many congenitally asthenic or badly trained young ath-letes retired with badly dilated and extremely irritable hearts. Permanent damage is notuncommon. HEART DISEASE-EARLY DIAGNOSIS 593 It cannot be true of the heart which had weakened and dilated under anacute toxemia of the sort associated with acute endocarditis or myocarditisor one which is more or less continuously subjected to chronic toxemia orsepsis and recurrent or persistent overstrain. Fortunately, however, from its large primary reserve fund enough usuallyis left available to keep even these hearts safe from actual disaster to their. Fig. 297.—Normal heart, taken in inspiratory phase. Transverse measurement 13 cm. possessors until the necessary relief occurs, and some further self-protection isafforded the patient by the subjective sense of weakness, or an actual physicaldisability, which limits his activity during this period, but which he, unwatchedand uninstructed, all too frequently disregards. brake That no damage is done in such cases is hardly conceivable nor is it inaccord either with clinical experience or experimental The automatic 594 MEDICAL DIAGNOSIS Big normalhearts rare ornon-existent. Exaggerated Estimate of the Normal Dimensions of the Heart.—No radiographic examples of a normal heart of excessive size (exceeding in total transverse diameter) have come under the authors observation.(See Cohns Table under 429.) Damagingerror. A commontype.
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