Care Of The Heart In The Young
( Originally Published 1921 )
Can a healthy young heart be torn or stretched as the result of its own activity? This is a difficult question to answer. The negative answer is certainly true with most children under fifteen or sixteen years of age. In the young child the heart is so large in proportion to the size of the child that no activity can possibly do harm. The soft, young blood vessels can not offer resistance enough to enable the .heart to injure itself by contracting too hard. This is true up to fifteen or sixteen years of age, and after this time some hearts probably may be injured by their own activities. So, as far as exertion goes, a healthy child's heart can be forgotten.
The danger with the hearts of children is that they may be damaged by some form of infection or inflammation. They are susceptible to rheumatism and everything that pertains to rheumatism, such as tonsilitis, St. Vitus's dance, and the blood poisoning that sometimes follows measles. Any complaint of muscular discomfort or distress in the joints of a child should receive prompt and careful attention. The old theory of growing pains allowed rheumatism to be neglected in a great many children, and rheumatism afterward developed into heart troubles. Rheumatism is so insidious and so dangerous that it is better to err on the side of over anxiety than to let any child be subjected Unnecessarily to a lifelong invalidism which comes from rheumatic destruction of the valves of the heart.
When the heart of a Child is known to have been the seat of inflammation, a heavy responsibility is imposed upon the physician. He must decide how active the trouble is and how long the child should be kept quiet, and when it will be improved by exercise.
The labor and inconvenience imposed upon the family by a child who is confined to bed for a year is so great that the physician is often compelled to emphasize strongly its importance in order to obtain obedience. About the time that the necessary period of rest is over, the family has become resigned to its task, and has become so fearful of letting the little heart patient do anything that it is then sometimes hard to obtain even a sufficient degree of liberty for the child. It is often the privilege of the heart specialist to come in at this time. He reaps the results of the other physician's laborious months of care. Even the physician in attendance may have become timid, and when the time for greater liberty comes, he sometimes shrinks from the responsibility of allowing it. Liberation of a child from its period of confinement, even tho a responsible task, is one of the pleasantest which come in the course of the specialist's work with disorders of the heart.