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October 7, 1939

Die Koronarinsuffizienz

JAMA. 1939;113(15):1436. doi:10.1001/jama.1939.02800400064030

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In this short monograph the author develops the argument that coronary insufficiency constitutes an important form of heart disease. By coronary insufficiency is meant an inadequate blood supply to the heart relative to the work that it is doing. This coronary insufficiency may be acute or chronic and it may lead to heart failure. The electrocardiogram expresses coronary insufficiency through its abnormalities, particularly by deviations of the S-T segment. Anatomically the evidence of coronary insufficiency is found in microscopic focal regions of degeneration and necrosis disseminated through the area which was ischemic. Clinically the expression of the coronary insufficiency is anginal pain. Coronary insufficiency may arise (1) through mechanical interference with coronary blood flow, (2) through impairment in the quality of the coronary blood as far as its oxygen content is concerned or (3) through an increase in the work of the heart with which the coronary blood supply cannot

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