Abstract
Though the etiology of cardiac asthma is unknown, a markedly increased cardiac output and blood velocity throughout the body and especially the lungs are according to Eppinger, Papp and Schwartz 1 significant factors. They explain the attack by a relatively left ventricular insufficiency dependent on the excess of blood brought to the lungs and heart. In view of the convincing nature of their experiments the writer has attempted to check the circulatory overflow in the periphery by the compression of the veins in the four extremities. This is conveniently performed by applying four blood pressure cuffs around the extremities as near to the trunk as possible. These cuffs are all in series and connect with an ordinary blood pressure manometer and rubber bulb. We have called the apparatus the “Venostat.” (Fig. 1.)
The cuffs are gradually inflated up to diastolic pressure and maintained at this level for 10 to 12 minutes. They are then very gradually deflated.
The application of this procedure during a cardio-asthmatic attack relieves the symptoms in about 5 minutes, and frequently terminates the attack by the time the treatment has been completed. Objectively sonorous and sibilant rales that may be present over the lungs become very faint or disappear entirely.
During the treatment the extremities become engorged due to compression of the veins. The arteries remain patent. A considerable volume of the Mood now collects in all the four extremities.
The cardiac outline becomes slightly reduced on the X-ray plate. Even the slight diminution in the cardiac silhouette as shown recently corresponds with great changes in the volume of the heart. Thus the heart and lungs are temporarily unloaded. When one recalls the fact that both of these organs are never completely at rest during life—even this partial rest for a relative short time may be sufficient for the heart to recuperate.
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