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October 28, 1939

A HITHERTO UNDESCRIBED SURGICAL PROCEDURE RELIEVING ATTACKS OF ANGINA PECTORIS: ANATOMIC AND PHYSIOLOGIC BASIS

JAMA. 1939;113(18):1619-1623. doi:10.1001/jama.1939.02800430011003
Abstract

Despite the various approaches to the problem of angina pectoris, uniformly complete relief from the condition by surgery or medicine has not been heretofore attained. On the assumption that coronary spasm occurs during attacks and is responsible for anginal pain, another operation has been designed which, so far as my experience permits of statements, seems to give uniform relief not by anesthesia but by prevention of coronary spasm.

It seems to be fairly generally accepted that coronary spasm occurs during seizures, but the mechanism is a much disputed question, confusion arising primarily from the reasonably well established normal behavior of these vessels. Any discussion on the surgical treatment is hardly complete without mentioning the name of Sir James Mackenzie,1 whose timely criticism marks the dividing line between faulty speculation and sound scientific reasoning.2 He suggested that a reinvestigation of the entire subject was necessary before any conclusions whatever

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