In most persons with heart disease, dyspnea is one of the earliest symptoms observed, and the tendency of a patient to become short of breath on exertion bears a close relation to his clinical condition. The physician often asks of his patient, "Do you get short of breath easily?" or "Do you get short of breath more easily than you did formerly?" and thereby indicates that he regards the question of dyspnea as having a direct bearing on the functional state of the heart. An increasing tendency to dyspnea is evidence of a failing cardiac reserve, while the ability to perform a greater amount of exercise without becoming short of breath indicates, in general, an improvement in the efficiency of the heart. In a limited number of patients, palpitation or cardiac pain are the presenting symptoms, and dyspnea does not assume so prominent a rôle, but in a much larger
McCLURE CW, PEABODY FW. RELATION OF VITAL CAPACITY OF LUNGS TO CLINICAL CONDITION OF PATIENTS WITH HEART DISEASE. JAMA. 1917;LXIX(23):1954–1959. doi:10.1001/jama.1917.02590500036009
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