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May 27, 1950


Author Affiliations

Staten Island, N. Y.

From the Cardiovascular Research Unit, Department of Medicine, United States Marine Hospital, Staten Island, N. Y.; consultant in cardiovascular disease (Dr. Russek).

JAMA. 1950;143(4):355-357. doi:10.1001/jama.1950.02910390027008

Alcohol has been regarded as a valuable drug in the treatment of angina pectoris since the earliest description of the disease by Heberden1 in 1786. It is rated by most contemporary authorities as one of the few effective coronary vasodilators, second only to the nitrites.2 Indeed, the effect of 1 or 2 ounces (30 to 60 cc.) of whisky or brandy in terminating an anginal attack is said to be comparable in many instances to the results obtained with glyceryl trinitrate. Nevertheless, it is in the prevention rather than in the treatment of these episodes that alcohol has been deemed of particular clinical value.2b Physicians frequently prescribe it in angina pectoris as a routine prophylactic measure and especially before contemplated effort or excitement.

In spite of such wide therapeutic endorsement, surprisingly little is known regarding the actual effect of alcohol on disturbances of coronary blood flow in

Heberden, W.:  Some Account of Disorder of Breast , M. Tr. Roy. Coll. Physicians 2:59. 1786.
Goodman, L., and Gilman, A.: The Pharmacological Basis of Therapeutics , New York, The Macmillan Company, 1941.
White, P. D.: Heart Disease , New York, The Macmillan Company, 1931, p. 436.
Levine, S. A.: Clinical Heart Disease , Philadelphia, W. B. Saunders Company, 1940, p. 116.
Dixon, W. E.:  Action of Alcohol on Circulation , J. Physiol. 35: 346, 1907.
Sulzer, R.:  Influence of Alcohol on Isolated Mammalian Heart , Heart 11:141, 1924.
Gilbert, N. C., and Fenn, G. K.:  Effect of Purine Base Diuretics on Coronary Flow , Arch. Int. Med. 44: 118 ( (July) ) 1929.Article
Jetter, W. W.:  Chemical and Clinical Diagnosis of Acute Alcoholism , New England J. Med. 221:1019, 1939.Article
Miles, W. R., in Emerson, H., and others: The Psychologic Effect of Alcohol in Man , New York, The Macmillan Company, 1932.
Evans, W., and Hoyle, C.:  Prevention and Treatment of Individual Attacks of Angina Pectoris (Angina of Effort) , Quart. J. Med. 3:105, 1934.
Stearns, S.; Riseman, J. E. F., and Gray, W.:  Alcohol in the Treatment of Angina Pectoris , New England J. Med. 234: 578, 1946.Article
Dock, W.:  Angina Pectoris, The Neuralgic Features of the Classic Form of Heberden's Disease , M. Clin. North America 33:635, 1949.
Russek, H. I.; Smith, R. H.; Baum, W.; Neagle, C., and Regan, F. D.:  Influence of Saline, Papaverine, Nitroglycerine and Ethyl Alcohol on the Electrocardiographic Response to Standard Exercise , Circulation 1: 700, 1950.Article
The Master test is a procedure in which the patient ascends and descends a two-step staircase twenty to thirty times, depending on age, sex and weight. Electrocardiograms are recorded immediately after exercise and at two minute intervals thereafter for a period of ten minutes. A depression of the RS-T segment in excess of 0.5 mm. in any of the tracings is regarded as abnormal.
Master, A. M., and others:  The Electrocardiogram After Standard Exercise as a Functional Test of the Heart , Am. Heart J. 24:277, 1942.