ANGINA PECTORIS


The consumption of alcohol and nicotine should be decreased on a frequent recurrence of attacks. Very important also is that patients should be spared every excitement, though this advice nowadays is purely a theoretical prescription. We must resort, therefore, to medicines.


ITS TREATMENT AND PREVENTION.

THERE are diverse illnesses that appear at odd seasons in variable frequency without any definite reasons for their origin being timely discovered.

Almost for the last twenty years we have all, no doubt, had to practically experience, unfortunately, the extraordinarily adverse effects of universal economic depression, many of us having to suffer from an undue measure of perpetual worry and excitement as a result of these deplorable times.

It is quite explicable, therefore, that our constant struggle for a bare existence, due to a worldwide insecure economic condition, when, not only does the burden of our cares in professional life weigh heavily upon us, but also the thought for the future adds greatly to a never-ceasing fount of cares, cannot leave our bodies unscathed. And so, in fact, there has developed in recent years a certain group of heart complaints, which were known indeed in the good old peaceful days, but by no means to such an extent as they prevail to-day.

As this illness develops but gradually and the primary symptoms are often times not noticed, precious time is frequently lost and the treatment given unfortunately at too late a stage is therefore unable to check the decline. With the following I will therefore endeavour to exhaustively explain this novel form of malignant heart trouble and show with what remedies and prescriptions it can be prevented and alleviated.

The peculiar part about this disease is that no symptomatic illness need precede it, as for instance rheumatism in the joints as a forerunner of cardiac valve trouble. The patient need not actually have ever felt ill, on the other hand, however, he may, from some reason or other, have had a series of worries climbing the stairs, he must frequently stop and stand still for a space on account of a stabbing, drawing pain emanating from the heart that mostly extends right down into the left arm. A cold sweat and a terrible choking sensation, as if an invisible hand were strangling him and a feeling of impending death, overcome him.

This terrible sensation and agony only last for a short time, then disappear leaving no after-affects whatever. The sufferer thereupon continues his way wondering whatever could have so suddenly befallen him. Sometimes such a victim may find really some tangible cause, such as over-strenuous walk or the weather mayhap was extremely stormy, making it very difficult for him to get along; perchance he had eaten not wisely but too well just before he went out, or he had had a very exciting day at the office or the like. As often as not, however, the reason for such an attack cannot be found, despite considerable reflection as to its sudden appearance. Such an attack may happen again after but a short interval; it may, however, not reappear for years.

Now what mysterious illness can this be to befall a person so suddenly? Medical men know these malignant attacks as angina pectoris, which means more or less in plain English “constriction of the chest”.

Very interesting is the difference in frequency of this complaint upon men and women. Of 100 such cases observed, 97 of these are man and only 3 women. This statistical fact also indicates what a considerable part professional worries play in the cause of an illness.

But we will now come to speak of a peculiar, extremely important fact. The very same symptoms, exactly the same attacks, a like terrible feeling of impending death may all be the cause of either a perfectly harmless indisposition or, on the other hand, of a grave illness. Thee exists namely, beside angina pectoris, also a pseudo form of this affection. The real malady is due to a material change occurring in the small blood vessels situated in the heart muscles ( coronary arteries) which, despite their smallness, have the very important duty of nourishing the heart muscle in which they are embedded.

Should these vessels, for instance, be thickened through calcification to such a degree that the blood can no longer pass through, in the same moment the supply of blood to the heart muscle ceases and a sudden death inevitably results. There is one comfort, however, and that is only a part of the attacks discussed are caused by such organic changes. In most cases, the blood vessels have not undergone a change at all, breathlessness occurring as a result of the nerves, that regulate the contraction and dilatation of the heart vessels, being defective for some reason or other.

The heart vessels contract in a cramped way, causing the same distressing symptoms, feeling of impending death and radiating pain as occur by a genuine calcification of the coronary arteries. The vital difference is that in the case of a simple nervous defect, the heart vessels open again and normal functioning is resumed, whereas in calcification, the vessels remain closed, the heart succumbing from a lack of blood.

Leo Bonnin