Although recognized pathologically for many years and discussed clinically since the Lumleian Lectures of Sir William Osler in 1910,1 the syndrome accompanying acute coronary occlusion was recognized by very few as a definite clinical entity before the appearance of the now classic paper of Wearn in 1923.2 Since that time, there have been added to Wearn's nineteen cases some hundred of others, and numerous careful studies of symptoms, physical signs, blood pressure curves, electrocardiographic changes and other observations have been reported. From this extensive literature may be gathered, among others, three significant facts:
1. Coronary occlusion, though variable in its manifestations, is established as a clinical entity and the diagnosis can be made clinically in many cases.
2. Nevertheless, because of the variability of the symptoms and the frequency with which they suggest diseases of other organs, the diagnosis is often extremely difficult, and sometimes impossible, to make.
PILCHER C. THE SURGICAL SIGNIFICANCE OF CORONARY OCCLUSIONREPORTS OF TWO CASES. Arch Surg. 1929;18(4):2040-2045. doi:10.1001/archsurg.1929.01140131144079