Effect of Transthoracic Endoscopic Sympathectomy on the Cardiac Neurovegetative Equilibrium and on Angina Pectoris

¹ Fulbright Research Scholar 1957/58., The Medical and Surgical Clinics of the University of Innsbruck, Austria.
² The Medical and Surgical Clinics of the University of Innsbruck, Austria.

In the majority of 16 non-cardiac and in two angina pectoris patients, unilateral or bilateral endoscopic transthoracic sympathectomy (method of Kux) was followed by signs of augmented cholinergic preponderance in cardiac dynamics (especially prolongation of the Isometric period of the left ventricle).

An opposite type of reaction in a minority of instances is tentatively explained on the basis of Cannon's "law of denervation" (=oversensitivity of sympathetically denervated structures to remaining catecholamines, e.g. circulating epinephrine).

Marked clinical improvement In two cases of angina pectoris (like that after other types of cardiac sympathetic denervation) is attributed to a reduction of angina-producing norepinephrine discharges into the poorly vascularized myocardium of individuals with coronary atherosclerosis.