ANGINA PECTORIS—TRUE AND FALSE.

Abstract

True angina pectoris is, comparatively speaking, an uncommon condition. The mechanism involved in its pathogenesis is imperfectly understood, and the views found recorded on the subject in medical literature are, for the most part, hypothetical. Two facts, however, are generally accepted: First, that structural changes of the cardio-vascular system are present in the immense majority of cases, the chief among them being arterial sclerosis, especially of the coronaries, aortic regurgitation, aortitis (syphilitic?), hypertrophy, aortic aneurism, adherent pericardium and myocardial degeneration—fatty and fibroid. These lesions may be variously combined and the instances in which a certain grade of calcification of the coronary arteries and root of the aorta, associated with more or less myocardial degeneration, has not been found in evidence postmortem, are of rare occurrence. The second fact which passes current is that irritation or disturbance of the cardiac sensory nerves exists. Unfortunately most of the leading theories concerning the