ANGINA PECTORIS (Lat. tightening of the chest or heart), or HEART-STROKE. It is characterized by intense pain and sense of con striction, which occur in paroxysms begin ning oier the region of the heart, or deep in the chest, and extending toward the left shoulder. The attacks are apt to appear in succession, and ultimately they kill the patient. As to the true pathological basis of angina pectoris we are still uncertain. Changes in the heart, aorta, and arteries, varying from extensive valvular disease to a mild arterio-sclerosis, have been described. These changes are. however,not constant, and are also found in cases which die with no symptoms of angina. There is usually disease of the coro nary or heart arteries, of the nature of an arte riosclerosis or thickening of the walls. This may be especially marked at the origin of the vessels, and leads to a diminution in lumen. Various theories have been advanced as to the true nature of angina. It has been considered as a neuralgia of the cardiac nerves, as a cramp of the heart muscle, as due to extreme dilatation of the heart—the tense muscle pressing the nerve endings—and as a temporary anamia of the heart muscle doe to disease or spasm of the ves sels supplying it with blood. It must be admit
ted, however, that such suggestions are purely theoretical, and that a definite pathological basis of angina is as yet undetermined. Angina pec toris is a disease of adult life, occurring most frequently between the ages of forty and fifty. The paroxysms may be induced by any excess in diet, by exertion, as walking uphill or against a strong wind, or by mental emotions. It is there fore advisable for those who have had an attack of angina to lead a quiet. regular life. avoid ex cesses of all kinds, and particularly refrain from mental excitement. During an attack the physi cian usually administers morphine, nitrite of amyl, nitro-glycerin, or chloroform.