The soldier's heart and the effort syndrome / by Sir Thomas Lewis.

  • Lewis, Thomas, Sir, 1881-1945.
Date:
1940
Catalogue details

Licence: In copyright

Credit: The soldier's heart and the effort syndrome / by Sir Thomas Lewis. Source: Wellcome Collection.

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    II.—DEFINITION OF EFFORT SYNDROME. When a healthy man takes exercise, and this exercise is sufficiently stressful or prolonged, he becomes aware at the time of the effort, or after it has ceased, of certain symptoms and he presents certain physical signs. The most notable of his symptoms is breathlessness, a symptom which comes during the exercise and continues with diminishing intensity for a variable period afterwards. During the exercise, consciousness of the heart beat may appear, giddiness, faintness, or fatigue may be added. After the exercise, aching of the limbs, tremulousness and exhaustion, are sometimes experienced ; at a later period, stiffness of the muscles, a feeling of lassitude and sometimes actual malaise and tremulousness are noticed. In cases of extreme effort, pain over the precordial region, at first aching but exceptionally more violent and widespread, may be felt. During the period of exercise the heart rate and blood pressure are raised ; the nostrils are dilated, the accessory muscles of respiration are brought into action to increase the tidal flow of air ; the cardiac impulse becomes more diffuse and prominent ; the sounds alter, systolic murmurs may appear at base or apex. To these physiological symptoms and signs briefly described as a group I apply the term c' physiological syndrome of effortThe term is used as a convenient description of the chief changes, subjective or