A Study of the Erythrocytes in Congestive Heart Failure, and Their Relation to Blood Viscosity

Markson, Arthur (1932) A Study of the Erythrocytes in Congestive Heart Failure, and Their Relation to Blood Viscosity. MD thesis, University of Glasgow.

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Abstract

Heart failure may be described as a condition in which, with lessening of the muscular power of the heart, an efficient circulation cannot be maintained, so that the tissues fail to receive a sufficient amount of oxygen, and to be adequately relieved of their waste products of metabolism, such as carbon dioxide. The congestive type of heart failure is present when, with failure of the right side of the heart, associated with diminution in velocity of the blood flow, stasis occurs in the pulmonary and systemic circulations. The conspicuous clinical symptom of congestive cardiac failure is dyspnoea, which, as Lewis (78) explains, becomes more distressing even at rest, with increase in the venous congestion, the latter being recognised by such signs as engorgement of veins, cyanosis, hepatic enlargement, scanty, high-coloured urine, dropsy, and the signs of congested and oedematous lungs. While the red blood corpuscles, which function as transporters of oxygen, and are also to some extent concerned with the carriage of carbon dioxide, have been studied fairly extensively in heart failure with venous congestion, it is noticeable from the literature that much more attention has generally been directed to variations occurring in their number, than to possible changes occurring individual red cells, as for example in their size. For the purpose of this thesis, therefore, besides giving a general resume of the literature, I have carried out an investigation into the volume and diameter of the erythrocytes in congestive heart failure, as well as studying, at the same time, their number and haemoglobin content, so that a more complete picture of possible changes occurring in red cells in this condition might be presented. As the erythrocytes also play an important part in the viscosity of the blood, variations in which a reknown to occur in cardiac failure (as indicated in the survey of the literature), it was considered of interest to relate the study of the size and number of the red cells to a study of the blood viscosity, which was accordingly undertaken. Congestive heart failure was in the majority of cases in this investigation secondary to chronic valvular disease, as for exanple, mitralstenosis, or aortic regurgitation with secondary mitral regurgitation, but it has also been secondary to other conditions, such as chronic bronchitis and emphysema, adherent pericardium, arteriosclerosis, and chronic nephritis. The plan of the investigation was to study a series of normal subjects in order to Obtain standard figures for comparison, for the technique employed, and with the same technique, to study a series of cases of well-compensated heart disease, and a series of cases of congestive heart failure. It was considered of interest to add the compensated cases, so that the results in cardiac failure might be compared with those obtained in cases where the equilibrium of the circulation was still maintained. In many of the heart failure cases, observations were also made when improvement in clinical condition occurred, and in four of the cases, a more detailed study was made, with frequent determinations, to show the effect of exacerbations and remissions of the circulatory symptoms. The effects of oxygen administration, venesection, and diuresis have also been studied. As failure of the circulation maybe considered to occur temporarily in severe exercise in normal persons, it was considered of interest, in addition to studying cases of cardiac failure, to study normal subjects under such conditions, and this was done in three subjects.

Item Type: Thesis (MD)
Qualification Level: Doctoral
Keywords: Medicine
Date of Award: 1932
Depositing User: Enlighten Team
Unique ID: glathesis:1932-79934
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 31 Mar 2020 09:09
Last Modified: 31 Mar 2020 09:09
URI: http://theses.gla.ac.uk/id/eprint/79934

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