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May 21, 1938

PRESSURE ON THE BRACHIAL PLEXUS CAUSING SIMULATION OF CORONARY DISEASE

Author Affiliations

BOSTON

From the Cardiac Clinic of the Massachusetts Memorial Hospitals.

JAMA. 1938;110(21):1724-1726. doi:10.1001/jama.1938.02790210004002
Abstract

A series of patients has been observed in which the pressure of a cervical rib or the scalenus anticus muscle on the brachial plexus has been the cause of pain simulating angina pectoris. It is obvious that these diagnoses differ significantly in prognostic and therapeutic implications. The delay experienced by some of these patients before the correct diagnosis was achieved gives me ground for the belief that some discussion of the subject may prove timely.

Pain due to pressure on the brachial plexus is given but scant attention in nonsurgical literature. The occurrence of precordial pain and the simulation of angina pectoris or coronary thrombosis is rarely mentioned.

GENERAL DESCRIPTION  Fischel of Prague is said to have found cervical ribs in 1 per cent of all autopsies.1 Adson and Coffey2 state that 55 per cent of the persons in whom they found cervical ribs to be present had

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