Coronary Sclerosis

Categories: Uncategorized
Sources: Disturbances Of The Heart

While disease of the coronary arteries may occur without general

arteriosclerosis, it is so frequently associated with it that it is

necessary to give a brief description of the general disease.

Arteriosclerosis or arteriocapillary fibrosis is really a

physiologic process naturally accompanying old age, of which it is a

part or the cause, and it should be considered a pathologic

condition only when it occurs prematurel . It may, however, occur at

almost any age after 30, and is beginning to be frequent between 40

and 50. In rare instances it may occur between 20 and 30, and even

in childhood and youth. It is much more frequent in men than in

women. Its most common cause is hypertension; in fact, hypertension

generally precedes it. The most frequent cause of hypertension today

is the strenuousness of life, the next most frequent cause being the

toxins circulating in the blood from overeating, overdrinking,

overuse of tobacco and the overuse of caffein in the form of coffee,

tea or caffein drinks. Another common cause of arteriosclerosis

occurring too early is the occurrence of some serious infection in a

person, typhoid fever and sepsis being most frequent. Syphilis is a

frequent cause, especially of that form of arteriosclerosis which

shows the greatest amount of disease in the aorta. Mercury used in

the treatment of syphilis is more liable, however, than syphilis to

be the cause of arteriosclerosis. Although this drug, even with the

arsenic injections now in vogue, is necessary for the cure of

syphilis, it probably tends to raise the blood pressure by

irritating the kidneys and by diminishing the thyroid secretion,

both of these occurrences predisposing to arteriosclerosis. From the

fact that lead poisoning causes an increased blood pressure, lead is

a probable cause of arteriosclerosis. With the greater knowledge of

the danger of poisoning possessed by those who work in lead, chronic

lead poisoning is becoming rare, as evidenced by the lessening

frequency of wrist drop and lead colic.



Chronic nephritis is often a coincident disease, but the causes of

the arteriosclerosis and the nephritis are generally the same.

Alcohol, except as a part of overeating and as a disturber of the

digestion, is perhaps not a direct cause of arteriosclerosis, as

alcohol is a vasodilator. Hard physical labor and severe athletic

work may cause arteriosclerosis to develop, and it is liable to

develop in the arteries of the parts most used.



Hypertension is generally a prelude to arteriosclerosis, and

everything which tends to increase tension promotes the disease;

everything which tends to diminish tension more or less inhibits the

disease. Therefore a subsecretion of the thyroid predisposes to

arteriosclerosis, and increased secretion of the suprarenals

predisposes to arteriosclerosis, the thyroid furnishing vasodilator

substance and the suprarenals vasopressor substance to the blood.

Furthermore. if these secretions are abnormal, protein metabolism is

more or less disturbed.



While arteriosclerosis often occurs coincidently with gout, and gout

apparently may be a cause of arteriosclerosis, still the two

diseases are widely dissociated, and the causes are not the same.



Although the arterial pressure has been high before arteriosclerosis

developed, and may remain high for some time in the arteries, unless

the heart fails, the distal peripheral pressure, as in the fingers

and toes, may be poor in spite of the high blood pressure. When the

left heart begins to fail, pendent edema readily occurs.