LACTIC ACID PRODUCTION DURING REST AND AFTER EXERCISE IN SUBJECTS WITH VARIOUS TYPES OF HEART DISEASE WITH SPECIAL REFERENCE TO CONGENITAL HEART DISEASE 1

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Abstract
The level of the concentration of lactic acid in the venous blood was utilized as a measure of estimating tissue anoxia. Blood lactic values were determined in a series of 39 individuals at rest and after the performance of a measured amount of mild exercise. The series was divided into the following: Normals, those suffering from acquired heart disease, and those afflicted with congenital heart disease. The congenital heart group comprised 18 cases, and was divided into two groups, the cyanotic group (veno-arterial shunt) and acya-notic group (arterio-venous shunt). An abnormal increase in blood lactate was found in all cases except one of the cyanotic group and in about one-half of the cases of the acyanotic group after mild exercise, but the rise in the latter was not so great on the average as in the cyanotic group. It was concluded that tissue anoxia is not present at rest in either type of congenital heart disease, regardless of whether cyanosis is present or not. However, there was a greater liability to the development of tissue anoxia in the cyanotic group even after the performance of slight exercise, as compared to the acyanotic group. When dyspnea follows mild exercise, the presence of tissue anoxia may be assumed to be present, regardless of what specific cardiac defect is ultimately responsible.

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