Abstract
One of the factors in the causation of
cardiac oedema is a depletion of the plasma proteins
which results in a fall in the colloid osmotic
pressure of the blood. This depletion is due
principally to malnutrition, and it is suggested that
cases of cardiac oedema should be given diets containing
the maximum amount of protein compatible with
the digestive functions of the patients
The results are recorded of an investigation
of the plasma proteins in sixty-five patients,
consisting of twenty -three cases of heart failure
with oedema, sixteen cases of heart disease
unaccompanied by oedema, eight cases of Bright's
disease, five cases of tuberculosis, two cases
of ovarian carcinoma with gross ascites, a miscellaneous
group of eight cases and three junior
members of the hospital staff who were used as
"normals". In all ninety -one estimations were
made.
The protein content of the oedema fluid in
these cases was estimated on twenty -nine samples.
There is a distinct diminution in the plasma
proteins in cardiac oedema, 87.5 per cent. of
the cases having a plasma albumin content of less
than 3.2 gm. per cent., while 91 per cent, have a
colloid osmotic pressure of the blood below 29 cm
of water.
In heart disease without oedema there is only
a slight diminution in the plasma proteins as
compared with the normal, 87 per cent. of the
cases having a plasma albumin level greater than
3.2 gm. per cent., and 91 per cent. having a
colloid osmotic pressure greater than 29 cm. of
water.
In view of these findings it is suggested
that plasma protein deficiency plays an important
role in the aetiology of cardiac oedema.
The origin, functions and variations of the
plasma proteins are discussed in relation to
their role in the production of oedema.
The main cause for the plasma protein
depletion in cardiac oederna is shown to be
malnutrition.
In view of this latter finding it is suggested
that the dietary of patients with cardiac oedema
should contain the maximum amount of protein
compatible with their digestive powers.
