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September 1962

Coronary Heart Disease Treated by Operation: Mobile Components

Author Affiliations

Professor of Cardiovascular Surgery, Western Reserve University and University Hospitals (Dr. Beck); Senior Instructor in Surgery, Cardiovascular Section, Western Reserve University (Dr. Leighninger).

Arch Surg. 1962;85(3):383-389. doi:10.1001/archsurg.1962.01310030031005

Two Components of the Disease  Coronary artery disease has 2 components. One is structural disease in arteries and muscle as found by necropsy examination of the heart. The other component consists of the clinical manifestations of the disease. These are anginal pain and fibrillating electricity. The latter produces the fatal heart attack (Figure). In many instances morbid anatomy does not adequately explain the genesis of anginal pain and fibrillating death. A similar statement can be made concerning the absence of relationship between structure in the brain and the clinical manifestations of status epilepticus. The anatomy in the heart scarcely explains status anginosis. Mild structural disease may be accompanied by incapacitating pain, and severe structural disease may be accompanied by no anginal pain. The anatomical specimen does not have a definite cause and effect relationship to the clinical manifestations of the disease. This is the subject for presentation.The disease, when

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