On the causes of dyspnoea and cardiac failure in high altitudes / by Frank Donaldson, jr.

  • Donaldson, Frank.
Date:
[1886]
Catalogue details

Licence: Public Domain Mark

Credit: On the causes of dyspnoea and cardiac failure in high altitudes / by Frank Donaldson, jr. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Three clays before, Mr. C. had left New York City, feeling well, although for two or three months before he had noticed that he became easily fatigued, had dys- peptic symptoms, lost flesh, and spent restless nights. When he reached Plattsburg the evening before (the altitude of which is 150 feet above sea-level) he felt better than when he left New York, slept unusually well during the night, and started at eight in the morning for St. Regis Lake. When he reached an altitude of about 1000 feet his breathing became difficult, and, as he reached higher altitudes, the difficulty increased, and was accompanied by cardiac palpitation and a sense of oppression in the epigastrium. The dyspnoea and oppression became so urgent before he reached St. Regis (the altitude of which is about 2000 feet) that his friends had to support him, and, when taken from the carriage on his arrival, he was thought to be dying. A careful physical examination twenty-four hours after showed a diffused, indistinct cardiac impulse ; the area of praecordial dulness was greatly increased both to the right and left. The first sound of the heart could not be made out; its time was occupied by a loud systolic murmur. The pulse was rapid, feeble, irregular in force, and at times intermittent; fine rales were heard at the base of both lungs. One examination of his urine gave negative results. After treating him for three days, with little apparent improvement in his cardiac symptoms, 1 advised that he should be taken to a lower altitude. When he reached Plattsburg on his return his dysp- noea was markedly relieved; when he reached his country home on the Hudson he had so far improved that he was able to walk on a level, and to lie down with his head and shoulders slightly elevated, although his dyspnoea, epigastric oppression, and irregular heart- action continued; his feet soon became oedematous, and six weeks later he died with general anasarca and heart insufficiency. No post-mortem examination was made. His family physician told me, some time after, that hi’ had never detected signs of cardiac disease until his return from the mountains, although he carefully