Angina Pectoris

Categories: Uncategorized
Sources: 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

previously described.