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January 7, 1939


Author Affiliations


From the Department of Pharmacology, Cornell University Medical College, and the Cardiac Clinics of the Beth Israel Hospital and the Hospital for Joint Diseases.

JAMA. 1939;112(1):1-6. doi:10.1001/jama.1939.02800010003001

The use of drugs in coronary disease resolves itself into the treatment of several symptoms and functional disorders of the heart and circulation. There are at present no chemical agents that can materially influence directly the course of the structural abnormality in the heart muscle and its blood vessels. Therefore, drugs have no place in the treatment of coronary disease if the subject is free of symptoms or of manifest disorders of function. The one exception is cardiovascular syphilis with coronary involvement.

The chief specific objectives toward which drug therapy is directed in the course of coronary disease are (1) pain; (2) nervous symptoms: apprehension, anxiety and restlessness; (3) congestive heart failure; (4) paroxysmal dyspnea; (5) shock, and (6) disorders of heart rhythm (auricular fibrillation or flutter, ventricular tachycardia).

The agents most frequently employed in connection with one or another of these phenomena are (1) nitrites, (2) xanthines (theobromine and