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(Chest. 1968;53:197-201.)
© 1968 American College of Chest Physicians

The Genesis of Angina Pectoris

Localized Cooling of Myocardium after Coronary Artery Occlusion. Cooling as Modified by Nitroglycerin and the Beck Operation

Fayiz A. Salwan M.D.1; David S. Leighninger M.D.1; and Claude S. Beck M.D., F.C.C.P.1

1 Claude Beck Cardiovascular Research Laboratory, Western Reserve University and University Hospitals

Temporary occlusion of the descending ramus of the left coronary artery reduced the intramural temperature of ischemic muscle by 4.47° F over a ten minute period of occlusion. Nitroglycerin had no measurable effect on reduction in temperature. The Beck operation, previously carried out, reduced temperature of ischemic muscle by 2° F. The fall was reduced by 50 per cent due to blood made available by the operation.

The cause of anginal pain is most likely electrical in nature and the electricity is created at the plane of contact between ischemic and non-ischemic muscle. Uniformity of blood supply is not painful and electrical formation is stable. Lack of uniformity is painful and electrical formation is unstable.

The reader will please observe that these data are based upon experiments with the chest open and under anesthesia. They are not measurements made on humans at the moment of pain. The relationship between the experiment and the human is speculative, but the data deserve consideration.






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Copyright © 1968 by the American College of Chest Physicians.