Heartbeat

“ Daily aerobic exercise will strengthen the heart, gradually slowing the heart's resting pulse rate, indicating that the heart has become much stronger, pumping more blood with each pulse. As the resting pulse drops the exercising heartbeat can be increased to double the resting rate. ”

“ A writer is so like a lover! And a talk with the right listener is so like an arm-in-arm walk in the moonlight with the soft heartbeat just felt through the folds of muslin and broadcloth! But it takes very little to spoil everything for writer, talker, lover. There are a great many cruel things besides poverty that freeze the genial current of the soul, as the poet of the Elegy calls it. Fire can stand any wind, but is easily blown out, and then come smouldering and smoke, and profitless, slow combustion without the cheerful blaze which sheds light all round it. ”

“ Operation Heartbeat is educating the public about the signs of cardiac arrest, reinforcing the importance of calling 911 immediately and promoting the benefits of knowing and administering cardiopulmonary resuscitation, until advanced care can be given to restore a normal heartbeat. ”

“ But why does the heart beat more rapidly and frequently in fear? In order to explain the cause of this phenomenon I must remind the reader of the observations which I made during my studies of the pulse, and of the circulation of the blood in the human brain during sleep. In a sleeping person, at the slightest noise or touch, the pulse becomes more frequent without the sleep being interrupted. This change is indispensable in order to accelerate the circulation and to utilise to the utmost the strength of the organism in preparing it for defence. ”

“ The first, and the most decisive, is the absolute stoppage of the heart's pulsations, noted for a duration of at least five minutes, not by the touch, but by the ear. "Death is certain," says the reporter of the commission named in 1848, by the Academy of Sciences, to award the prize of competition as to the signs of true death, "when positive cessation of pulsations of the heart in the subject has been ascertained, which is immediately followed, if it has not been preceded, by cessation of respiration, and of the functions of sensation and motion." ”

“ From the moment a human being begins to live, he begins to die.
Action of the Heart.—The alternate contraction and dilation of the muscles of the heart constitute the heart-beats or throbs of the pulse. These vary with the individual. In the average adult, the number of beats is seventy-two per minute. In the cases of Bonaparte and Wellington the number was less than fifty. Heat, food, and exercise increase its action, as cold, fasting, and sleep diminish it. Emotion of joy, grief, and fear also exert a modifying influence. ”

“ Thus in cold fits of agues, in hysteric palpitations of the heart, and when the body is much exhausted by hæmorrhages, or by fatigue, as well as in nervous fevers, the pulse becomes quick and small; and secondly, in all those cases if an increase of stimulus be added, by giving a little wine or opium; the quick small pulse becomes slower and larger, as any one may easily experience on himself, by counting his pulse after drinking one or two glasses of wine, when he is faint from hunger or fatigue. ”

“ SIGNS OF HEART WEAKNESS It should be remembered that a normal heart may slow to about 60 during sleep, and all nervous acceleration of the pulse may be differentiated during sleep by the fact that if the heart does not markedly slow, there is cardiac weakness or some general disturbance. There is also cardiac weakness if there is a tendency to yawn or to take long breaths after slight exertions or during exertion, or if there is a feeling of suffocation and the person suddenly wants the windows open, or cannot work, even for a few minutes, in a closed room. ”

“ What method might be followed with advantage in making a complete diagnosis of heart disease in older subjects?
A man of 60 consults us about his heart. He says that it has caused him a good deal of concern lately. More specifically he describes a sense of oppression behind the sternum as often as he exerts himself, and palpitation with consciousness of irregular [32] cardiac action when he goes to bed. We inquire for other familiar cardiac symptoms, such as pain, angina, fluttering, faintness, giddiness, and a sense of impending death. ”

“ Hence people in Grief, &c. labour under a double Disease, which, on account of the anxiety, weight, and oppression that is felt from the Blood stagnating about the Heart, is commonly termed Heart-breaking.
An Uneasiness or Anxiety, and Palpitation of the Heart, are the last Symptoms that are commonly felt of the [28] Night-mare, which proceed from the cause lately mention’d; as ’tis then necessary that the Heart should contract itself more frequently, in order to discharge the Blood collected in the Vena Cava, the right Sinus Venosus, and Auricle, during the fit. ”

“ Cardiac complications show themselves by shortness of breath, palpitations, hard intermittent, irregular or unequal pulse, blowing murmur with the first heart sound, and other signs of circulatory trouble. ”

“ A very remarkable thing in experiments is the quickness with which pain disturbs the motion of the heart, accelerates it, renders it irregular, &c. We can always at will hasten respiration, by making the animal suffer; now the acceleration of the pulse is always prior to that of respiration, which appears to be determined by it. I am persuaded that if the diseases of the heart were as frequent on the right side as the left, they would often produce this reflux and this pulsation of the veins. ”

“ In certain cases, under the {229} stress of emotion, the heart beat-rate may be faster than normal, but in a number of people who complain of palpitation, no rapid heart action is noted. What has happened is that something having called particular attention to the heart, the beating of the organ gets above the threshold of consciousness and then continues to be noted whenever attention is given it. This is of itself quite sufficient to cause a sense of discomfort in the heart region and there may be, owing to the solicitude about the organ, a great deal of complaint. ”

“ In such cases we have palpitation of the heart, both subjective and objective, a weak and compressible pulse, often irregularity of the heart’s action, singularly clear heart sounds, often, however, systolic murmurs at various orifices, increased frequency of heart and respiration to a disproportionate degree on slight exertion, strong pulsation of the carotids, and slight œdema of the ankles. ”

“ The second factor in spontaneous cure of the heart attack is relaxation. The exhaustion from the respiratory muscular efforts, together with the drowsy condition caused by the cerebral hyperemia and from the imperfectly aerated blood, causes finally a dulling of the mental acuity, and the nervous excitement abates, which, with the exhaustion, gives a relaxation of peripheral arterioles: the resistance to the flow of the blood is removed, the surface of the body becomes warm, the heart quiets down by the equalization of the circulation, and the paroxysm is over. ”

“ It is not so well known, even to physiologists that the volume of the heart may be affected by emotion. In several series of observations made under conditions of emotional excitement upon a large number of healthy men, candidates for civil service appointments, I recorded in a high percentage not only alterations in the rate and rhythm and force of the heart-beat, but temporary dilatation of the heart lasting during the period of excitement. ”

“ I am anxious to direct your attention, if it be but for a moment, to the fact that in many instances where præcordial oppression, pain, palpitation and faintness, with frequent small irregular pulse, are significant of serious disturbance of the action of the heart, there is no failure of the myocardium in the proper sense of the term, but only embarrassment of a temporary character. ”

“ Moreover, when the heart is quieted you may see movement surviving in the auricles, and latest in the right auricle; and at length all pulsation ceasing there, you may find in the blood itself a kind of undulation and obscure agitation or palpitation, the last indication of life. And anyone can perceive that the blood retains in itself to the last the heat which is the author of pulsation and life; if this heat is once wholly extinguished and the blood now is blood no more, but cruor, so there is left no hope of a return to life again. ”

“ There is no doubt, however, that anxiety about the heart will quicken or slow the pulse rate. When a patient comes to be examined for suspected heart trouble the pulse rate is almost sure to be higher than normal, even though there may be nothing the matter with the heart; the increase or decrease of the pulse beat is due to the anxiety lest some heart lesion should be discovered. ”

“ Usually the pulse beats four times during one respiration, but both in health and disease its frequency may be accelerated or retarded. In adults, there are from sixty-five to seventy-five beats in a minute, and yet in a few instances we have found, in health, only forty pulsations per minute. But when the heart beats from one hundred and twenty to one hundred and forty times a minute, there is reason to apprehend danger, and the case should receive the careful attention of a physician.
Irregularity of the pulse may be caused by disease of the brain, heart, stomach, or liver ”

“ These things, therefore, happen together or at the same instant: the tension of the heart, the pulse of its apex, which is felt externally by its striking against the chest, the thickening of its parietes, and the forcible expulsion of the blood it contains by the constriction of its ventricles.
Hence the very opposite of the opinions commonly received appears to be true; inasmuch as it is generally believed that when the heart strikes the breast and the pulse is felt without, the heart is dilated in its ventricles and is filled with blood ”

“ At the same time the heart’s action was greatly increased in frequency, there being sometimes more than 200 beats per minute, the pulse was soft, small, difficult to count, the respiration greatly increased in frequency, sometimes very shallow, with respiratory anxiety, and exceptionally severe general excitement and sense of impending death. ”

“ An irregular small pulse, is frequently the attendant of an emaciated constitution, putrid fevers, and consumptions; and this dangerous pulse too generally forebodes the approach of death. The more irregular the pulse grows, small, weak, trembling, and leaves off by irregular intervals, the sooner dissolution is at hand; till at last, the pulse entirely disappears, and life ceases. But dangerous as this pulse is, yet it must be observed, that it often appears in the strongest constitutions, as in sudden emotions of the mind, falls, &c. ”

“ Modifications of the peripheral circulation, manifested through pallor or turgescence of the skin and measured by changes recorded by the plethismograph in the volume of the limbs; modifications of the volume of the heart and of the rhythm and force of the beats recorded by the sphygmograph, and of arterial tension measured by the sphygmomonometer are common phenomena. (Fear is more particularly accompanied by pallor, and shame by turgescence—blushing. Anger in some is manifested by pallor and in others by turgescence, and so on.) Changes in rate of the heart-beats belong to popular knowledge. ”

“ When an otherwise apparently well person begins to complain of weariness, or perhaps drowsiness in the daytime and sleeplessness at night, or his sleep is disturbed, or be has feelings of mental depression, or he says that he "senses" his heart, perhaps for the first time in his life, with or without edema of the feet and legs, or pains referred to the heart or heart region, we should presuppose that there is weakening of the heart muscle until, by perfect examination, we have excluded the heart as being the cause of such disturbance. ”

“ For this it is not always convenient to employ the whole of the frog. The heart is therefore cut out, and make the subject of experiments, as to what conditions accelerate, and what retard, the rate and amplitude of its beat. When thus isolated, the heart tends of itself to come to a standstill, but if, by means of fine tubing, it be then subjected to interval blood pressure, its beating will be resumed, and will continue uninterrupted for a long time. By the influence of warmth, the frequency of the pulsation may be increased, but its amplitude diminished. ”

“ They may be reduced to a single formula: pain is associated with diminution and disorganisation of the vital functions.
1. It acts on the movements of the heart, generally decreasing its frequency; in extreme cases the slackening may go so far as to produce syncope. In animals submitted for experiment in the laboratory, even after removal of the encephalon, painful impressions diminish the cardiac contractions. In man, though the frequency of the pulse is sometimes increased in one form or another, there is always a modification of the rhythm appreciable by the sphygmograph. ”

“ And, indeed, when men saw the heart continue its pulsations some time after death, and even after removal from the body, and saw, moreover, that after pulsation had ceased it could be revived by the injection of warm blood, there seemed the strongest arguments in favor of the hypothesis. Unhappily for the hypothesis, the heart continues to beat long after all the blood has been pumped out of it, consequently its beating cannot be due to the stimulus of the blood. ”