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Angina Pectoris

person, attack, spasm and spasms


Angina Pectoris means literally breast pang. It is a very peculiar disease, and was first properly described by Dr. Heberden, who named it because of the sensation of strangling in the breast, which is its chief symptom (Latin, anqo, to strangle, and pectus, the breast).

Its cause is not properly known, but after death the hearts of those who suffered from it have been found the seat of degenerative changes, and, in particular, the coronary arteries, which come off from the commencement of the aorta, have been found bard and rigid by the deposit of lime salts in their walls—calcareous degeneration.

Symptoms.—The disease attacks in spasms, and between the spasms the person may be in apparently good health. The spasm commonly comes on when the person is walking or making some slight bodily exertion. It consists in a peculiar pain felt about the region of the heart, and extending to the left shoulder and down the left arm to the elbow. The pain may be aching or numbing, or give the impression of severe tightening. Under its influence the person instantly becomes still, and is possessed with the dread of impending death. His face is pale and haggard, the skin is covered with clammy sweat, and he has a sense of suffoca tion, although there is no difficulty in breath bug. At first, as a rule, the attack passes off in a short time, and the person is himself again.

But the spasm recurs after a longer or shorter interval. Gradually the intervals become shorter and the spasms last longer, and sooner or later the person (lies in an attack. Sometimes, how ever, long intervals occur between two attacks.

Neuralgia of the heart is sometimes spoken of. Its symptoms are those of angina. It is the term applied no disease of the heart is found to account for the spasms.

Treatment is directed to relieving the spasm when it occurs. All that can be done to ward off attacks is to avoid exertion or straining of any kind, excitement and fatigue, and excess in eating or drinking. To relieve the spasm stimulants are used, ammonia, brandy, or ether Or to 1 tea-spoonful). Of recent years nitrite of amyl has been found specially useful-5 drops are placed on a handkerchief and inhaled. Per sons liable to the attack should carry a small bottle with a tightly-fitting stopper, in which is placed a little cotton with 5 to 6 drops of the nitrite on it. As soon as the attack threatens, the vapour should be drawn up into the nos trils. The nitrite is also put up in little glass beads-5 drops in each globule. When required, one is crushed between the folds of a handker chief and inhalation practised. Nitro-glycerine is also a very useful drug, in tabloids of grain.