A contribution to the pathology of the coronary arteries of the heart : based upon an analysis of 238 cases in which the condition of these arteries was ascertained after death : with observations upon the relationship of disease of these vessels to sudden death and angina pectoris / by John Lindsay Steven, M.D., Physician and Lecturer on Clinical Medicine, Glasgow Royal Infirmary.

  • Steven, John Lindsay, 1859-1909.
Date:
[1898?]
Catalogue details

Licence: Public Domain Mark

Credit: A contribution to the pathology of the coronary arteries of the heart : based upon an analysis of 238 cases in which the condition of these arteries was ascertained after death : with observations upon the relationship of disease of these vessels to sudden death and angina pectoris / by John Lindsay Steven, M.D., Physician and Lecturer on Clinical Medicine, Glasgow Royal Infirmary. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    lead me tu believe that embolism of the coronary arteries as well as atheromatous disease may sometimes be the starting- point of attacks of angina pectoris. From these considerations then it may be concluded that any serious interference, especially if suddenly induced, with the liistological integrity of the cardiac fibre is a very frequent cause of angina pectoris. Turning now to the 15 cases in which the arteries were found to be diseased, I have to point out that in 9 of them typical angina pectoris may be admitted to have been present. In these nine cases the terms “angina pectoris,” “angina,” “ anginal pain,” “ anginous seizures ” were actually used in the clinical reports. The remaining (i were simply described as having suffered from “ cardiac pain,” but it may also be allowed in two or three of these, from tlie description given that the pain was of anginal character. We may say tlien that angina pectoris was present in from 10 to 15 per cent, of the 102 cases of disease of the cardiac arteries analysed in this paper. This percentage is perhaps not so great as one would have expected from the ordinary teaching on this subject, but it is large enough to prove that atheroma of the coronary arteries is a very important factor in the causation of this distressing symptom of heart disease. It is also evident that in cases with fibrous transformation of the heart-wall anuina pectoris is relatively a more frequent symptom than in cases where this change is not present. Associated with fibrous change, the symptom occurred about once in every 4 cases, without fibrous change about once in every 8 cases, in round numbers. CONCIATSIONS. From the analysis of tlic 288 cases dealt with in this paper I may draw the following general conclusions : (1) Although in many cases, especially of chronic cardiac or renal disease, we may, on careful consideration of all the phenomena, have good gnumds for sus})ecting the presence of atheromatous disease of the coronary arteries, there are no signs or symptoms which can be looked upon as positive or ])athognomonic.