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Source: Disturbances Of The Heart
This is a name applied to pain in the region of the heart caused by
a disturbance in the heart itself. Heart pains and heart aches from
various kinds of insufficiency of the heart, or heart weakness, are
not exactly what is understood by angina pectoris. It is largely an
occurrence in patients beyond the age of 30, and most frequently
occurs after 50, although attacks between the ages of 40 and 50 are
becoming more frequent. It is a disturbance of the heart which most
frequently attacks men, probably more than three fourths of all
cases of this disease occurring in men; in a large majority of the
cases the coronary arteries are diseased.
Various pains which are not true angina pectoris occur in the left
side of the chest; these have been called pseudo-anginas. They will
be referred to later. True angina pectoris probably does not occur
without some serious organic disease of the heart, mostly coronary
sclerosis, fatty degeneration of the heart muscle, adherent
pericarditis and perhaps some nerve degenerations. Various
explanations of the heart pang have been suggested, such as a spasm
or cramp of the heart muscle, sudden interference with the heart's
action, as adherent pericarditis, a sudden dilatation of the heart,
an interference with the usual stimuli from auricle to ventricle and
therefore a very irregular contraction, a sudden obstruction to the
blood flow through a coronary artery, or a sudden spasm from
irritation associated with some of the intercostal or more external
chest muscles causing besides the pang a sense of constriction.
Perhaps any one of these conditions may be a cause of the heart
pang, and no one be the only cause.
In a true angina, death is frequently instantaneous. In other
instances, death occurs in a few minutes or a few hours; or the
patient's life may be prolonged for days, with more or less constant
chest pains and frequent anginal attacks. Here there is a gradual
failing of the heart muscle, with circulatory insufficiency, until
the final heart pang occurs.
Anginal attacks before the age of 40, presumed, from a possible
narrowing of the aortic valve, to be due to coronary sclerosis, are
frequently due to a long previous attack of syphilis. In these
cases, active treatment of the supposed cause should be inaugurated,
including perhaps an injection of the arsenic specific, and
certainly a course of mercury and iodid, with all the general
measures for managing and treating general arteriosclerosis, as
Next: Angina Pectoris Symptoms