Monday, April 29, 2013

"Soldier's Heart"

Heart Disease in Civil War Soldiers

By Alfred Jay Bollet, M.D.

Heart symptoms often accompany anxiety, but the physical stresses of a soldier's life can also reveal underlying heart abnormalities. Given the limited diagnostic tools available (no electrocardiograms or radiographs) during the Civil War, the true cause of many soldiers' cardiac ailments baffled their physicians.

Dr. Jacob DaCosta, who also worked at Turner's Lane Hospital in Philadelphia, is credited with the first description of "soldier's heart" or "stress heart", a form of what i today considered psychogenic heart disease." Of the 300 cases DaCosta studied, most men had episodes of palpitation and shortness of breath, and some developed evidence of cardiac hypertrophy but not dilatation. DaCosta considered the findings a "functional disorder" and attributed then to "cardiac muscular exhaustion" Other physicians agreed, noting that the excitement of battle and "double quick" marching caused the syndrome of irritable heart.

During the war, 10,516 white and 100 black soldiers were discharged due to heart disease. Discharges due to valvular disease or "soldier's heart" were not separated out, but available records show that physicians did recognize various types of cardiac pathology. Valvular heart disease was diagnosed in 3,574 whites and 325 blacks; most undoubtedly resulted from rheumatic fever. Civil War physicians clearly were skilled at using a stethoscope to detect this form of heart disease.

Excerpted From: Civil War Medicine: Challenges and Triumphs by Alfred Jay Bollet, M.D.

IMAGE: Civil War era monaural stethoscope


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