Palpitation

“ Respiration is shallow, and abnormally frequent. The attacks of palpitation recur daily in some patients, in others at intervals of several days; they may occur entirely without exciting cause, or with a cause so trifling that it would not in a normal subject have produced any nervous excitement; the duration of the attacks varies from a few minutes to several hours, and they may occur either by day or by night; in the intervals between the attacks the functions of the heart and the arteries are conducted in a normal manner. ”

“ Nay, has not the blood itself or spirit an obscure palpitation inherent in it, which it has even appeared to me to retain after death? and it seems very questionable whether or not we are to say that life begins with the palpitation or beating of the heart. ”

“ 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. ”

“ You grow apprehensive about the palpitation of your heart, which is not at all diseased, but which flutters a little from time to time because the great nerve of the heart is tired, like the other great nerves and nerve-centers of your body. ”

“ Thus, for example, the perception or thought of a certain person may become, as the result of a given social episode, so linked with blushing or cardiac palpitation that whenever the former is thrust into consciousness, no matter how changed the conditions may be from those of the original episode, the physiological reaction of the blood vessels or heart is reproduced. ”

“ Soon there is an adaptation to the change—the functions regain their accustomed office—the palpitation of the heart subsides—the pulse, which might have been fluttering and intermitting, becomes regular, though still quick and full. ”

“ The hand or ear placed against the chest easily detects the unnatural beating. In some cases it is so violent that the motion may be seen at a distance. Palpitation is but a symptom, and in many instances not connected with disease of the structure of the heart or its membranes. A badly frightened animal may have palpitation. ”

“ Under this authority the term palpitation may be employed to mark those morbid motions which chiefly characterise this disease, notwithstanding that this term has been anticipated by Sauvages, as characteristic of another species of tremor [7] . The [23] separation of palpitation of the limbs (Palmos of Galen, Tremor Coactus of de la Boë) from tremor, is the more necessary to be insisted on, since the distinction may assist in leading to a knowledge of the seat of the disease. ”

“ Patients who are about to undergo a surgical operation are, however, not always in a state for receiving agreeable impressions, and they sometimes complain of palpitation of the heart, and a feeling of fulness in the head. ”

“ A very frequent complication of gastralgia is severe palpitation of the heart, but during the paroxysm itself the pulse, whether rapid or not, is commonly small, at first tense, and afterward soft, but not acquiring any considerable volume till the pain has ceased. ”

“ The action of the heart is disturbed as in stomach indigestion. Irritability of the heart and palpitation are in part due to anæmia and in part to mechanical pressure and reflex influences. The nervous, anæmic, thin dyspeptic has among his chief troubles a throbbing heart, which keeps him awake at night and fixes his attention upon this organ as the seat of his disease. ”

“ The disturbances of the circulatory system take the form of more or less severe palpitation, pain in the region of the heart, quick pulse, œdema of the eyelids, of the face, of the lower limbs, and even of the whole body. ”

“ Such a Patient has generally dark spots under his eyes, a sharp nose, and often flushes of hectic color in his cheeks, particularly when in the presence of company, and there is more or less palpitation of the heart. ”

“ The ventricles failing and coming to a stand, the motion still goes on in the auricles, and finally in the right auricle alone; and even when all motion has ceased, there the blood may still be seen affected with a kind of undulation and obscure palpitation or tremor, the last evidence of life. Every one, indeed, may perceive that the blood—this author of pulsation and life,—longest retains its heat ”

“ A too full habit is often the exciting cause of the palpitation, as may be seen by the patient being always liable on the slightest exertion to flushed face, dimness of sight, ringing in the ears, swelling of the limbs, and puffiness of the gums, sometimes to such an extent that the mouth will taste of blood. Such persons should carefully observe a moderate unstimulating and simple diet, and never allow the bowels to remain constipated more than a single day. ”

“ The general symptoms are pallor of the skin and mucous membranes, weakness and lassitude, shortness of breath, palpitation, a tendency to fainting, and usually also gastro-intestinal disturbance, headache and neuralgia. The heart is often dilated, and on auscultation the systolic murmurs associated with that condition are heard. ”

“ The force or intensity of the heart sounds is increased in high fever, in acute inflammation, in increase of the muscular walls of the heart with enlargement of the internal cavities, in functional disturbance from fear or other exciting cause, and in palpitation. ”

“ Some retain their excessive nervous excitability, are subject to palpitation of the heart, but only in very exceptional conditions have the attacks of pavor nocturnus exercised a lastingly injurious influence. ”

“ In such women, still at the climax of their physical powers and of their sexual needs, attacks of palpitation suddenly occur at irregular intervals, several times daily or less frequently. Associated with this increased frequency of the cardiac activity are an extremely distressing feeling of anxiety, a sensation of faintness, headache, vertigo, a weakness of the muscular system, and at times actual attacks of syncope. Physically, the women are extremely depressed, irritable, inclined to weep, unhappy, and weary of life. ”

“ 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. ”

“ A man about forty-five consults us and says that he has noticed recently that he gets out of breath easily; in tying his shoes he experiences some dizziness. He finds that he has palpitation of the heart and possibly pain over the precordial region now and then. ”

“ Though the patient's pulse is usually below forty and even after a rapid walk does not rise above fifty, she is in reasonably good health and during those years has buried two husbands. When I saw her she was compelled to go up and down stairs frequently and yet did not experience much difficulty. While patients suffering from palpitation would find it impossible, because of the discomfort produced, to make the journeys up and down stairs that she did, she felt only about as much respiratory discomfort as would come to a woman of her size. ”

“ Trembling, palpitation, stammering, blushing—not to speak of the pathological states which occur in neurosis—are due to modifications and changes in the blood-flow, in muscular action and in the working of the vital organs. These changes are not voluntary and conscious ones, they are determined by the Unconscious and come to us often with a shock of surprise. ”

“ A gentleman about 65 years of age had for about ten years been subject to an intermittent pulse, and to frequent palpitations of his heart. Lately the palpitations seemed to observe irregular periods, but the intermission of every third or fourth pulsation was almost perpetual. On giving him four drops of a saturated solution of arsenic from a two-ounce phial about every four hours for one day, not only the palpitation did not return, but the intermission ceased entirely, and did not return so long as he took the medicine, which was three or four days. ”

“ I found his pulse very quick, irregular and small: but I could find no new cause for the return of his complaints. He had alter this some smaller attacks: but in the night of the 23d he was seized with a violent fit of the same sort, with stretchings, and as if prickling sparks were flying continually out of the skin. He had palpitation of the heart, and complained of the want of breath: his left side turned cold, and his right side grew hotter. When I came he was grown better, but the pulse still very small, frequent and inordinate. ”

“ Since writing the above account, the dropsical collections were absorbed, and the palpitations and other symptoms moderated, so that he considered himself nearly well, and attended to his usual business. Within a few days, however, the symptoms have returned with more violence. The dyspnœa is at times very distressing; the pulse more irregular and intermittent; the palpitations are more constant. His sufferings from lying in bed are so increased, that in the most comfortable nights he passes, he sits up once in an hour or two. The appetite is keen. The legs begin to swell again. ”

“ Some again are black, pale, ruddy, sometimes their shoulders and shoulder blades ache, there is a leaping all over their bodies, sudden trembling, a palpitation of the heart, and that cardiaca passio, grief in the mouth of the stomach, which maketh the patient think his heart itself acheth, and sometimes suffocation, difficultas anhelitus, short breath, hard wind, strong pulse, swooning. ”

“ 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. ”

“ Two sounds are heard if we put our ear over the heart,—the first and longer as the blood is leading the organ, the second as it falls into the pockets of the two arteries, and the valves then striking together cause it. The first sound is mainly the noise made by the muscular tissue. During the first, the two ventricles contract; during the second the two auricles do so. The hand may feel the heart striking the ribs as it contracts,—a feeling called the impulse, or, if quicker and stronger than usual, palpitation. ”

“ Nervous and purely functional palpitations are probably confined to cases in which they are manifested at intervals appearing under the influence of some transient excitement, and continuing only for a few minutes at a time. ”

“ You ain't had a feelin' of heart burn after you eat, have you? Sometimes it don't take you that way, though; you just begin to have palpitations when you go up and down stairs and then you start to wakin' up in the night with shortness of breath. ”

“ Although they may be tolerably cheerful when in company, they prefer rather to be alone.
The countenance has often a gloomy and worn-down expression. The patient's friends frequently notice a great change. Large livid spots under the eyes is a common feature. Sudden flashes of heat may be noticed passing over the patient's face. He is liable also to palpitations. The pulse is very variable, generally too slow. ”

“ Palpitations of the heart, the missing of beats, and pains in the heart region frequently arise from this cause. It is through their effect upon the nervous system that worry, overstudy, undue excitement, and dissipation cause disturbances of the heart. ”

“ I lose all patience when I see the Doctor feeling his own pulse fifty times a day, and consulting half a dozen good friends if his heart beat a little quicker than usual—while I have palpitations every day of my life, and never think of complaining or fancying that I have a diseased heart! ”

“ It must be too obvious that the evidence adduced as to the nature of the proximate and occasional causes of this disease, is by no means conclusive. A reference to the test therefore which will be yielded by an examination of some of the more prominent symptoms, especially as to their agreement [53] with the supposed proximate cause, is more particularly demanded. Satisfied as to the importance of this part of the present undertaking, no apology is offered for the extent to which the examination is carried on.
If the palpitation and the attendant weakness of the limbs, &c. ”

“ The dyspnœa became more constant, and was occasionally attended by cough; the palpitations rather lessened in violence; the pulse was more irregular, and exceedingly intermittent. The abdomen and inferior extremities [25] were sometimes enormously distended with water, and afterwards subsided nearly to their usual size. One of the earliest, most frequent, and distressing symptoms, was an intense pain in the head. ”

“ During the whole time the breathing is difficult, the mouth froths very much, and the heart palpitates quickly, but irregularly. When the spasm is over the patient falls into a perfect stupor, during which she remains unconscious, but with all the limbs soft and moveable, except the fingers, which appear to grasp. The jaws generally remain closed, and so do the [338] eyes, but they may be easily opened, and will sometimes remain open; the breathing becomes powerful and loud, and the pulse beats with rapidity. ”