An inadequate circulation to the myocardium, particularly of the left ventricle, is primarily responsible for the cardiac disability in coronary artery disease. This varies in extent and distribution with the size and number of vessels involved by the sclerotic process and whether they are partially or completely occluded. Moreover, it may develop gradually or occur abruptly as from the sudden closure of one of the larger coronary arteries. In view of the great variation in these and other factors, it is not surprising that the clinical manifestations of coronary artery disease are varied and that sudden death may be the first intimation of the disease in some, whereas others may live for years after the appearance of the first symptom.
This report is based on the study of 420 cases of coronary artery disease in which the progress of the cardiac disability was analyzed with reference to the character of
SMITH FM, RATHE HW, PAUL WD. OBSERVATIONS ON THE CLINICAL COURSE OF CORONARY ARTERY DISEASE. JAMA. 1935;105(1):2-6. doi:10.1001/jama.1935.02760270004003