ANGINA PECTORIS. BREAST PANG. 



W. Williams describes a case of illness in the horse to which he 

 gives this name. When standing idle he had twitchings of the 

 pectoral muscles, and when exercised these and adjacent muscles 

 became violently convulsed, the left fore limb being alternately 

 fixed by spasm, and paralyzed so that it was useless and the ani- 

 mal fell if compelled to move. There was ' ' venous pulse, great 

 irregularity of the heart's action, a loud cooing or blowing sound 

 and strong impulse indicative of hypertrophy and a want of cor- 

 respondence between the cardiac energy and feeble pulse." It 

 was unfortunate that the murmur was not associated by the ob- 

 server with a particular heart sound, and with the right or left 

 side of the heart, and that hypertrophy was not diagnosed by 

 percussion, since the case can be of little value as it stands. 



Breast pang is usually associated with some disease of the heart ; 

 obstruction (usually calcification) of the coronary arteries, insuf- 

 ficiency of the aortic valves, calcareous degeneration of the aorta, 

 aortic aneurism, or fatty degeneration of the heart. I^oomis, 

 basing his view on dissections made by himself and others, re- 

 solves all of these into concurrent ischsemia of the heart, the cir- 

 culation in the coronary arteries being seriously interfered with. 

 ' ' That the sudden withdrawal of the supply of blood to a part may 

 occasion neuralgia is shown by the intense pain in the limb, which 

 directly follows embolism of the femoral artery. Moreover, gen- 

 eral anaemia, as is well known, favors the recurrence of neuralgia 

 in various situations. ' ' Inability of the heart to propel the blood 

 is to be explained in the same way. 



The difficulty of endorsing Williams' diagnosis lies in the fact 

 that the disease, so far as it is a distinct disease, is functional and 

 manifested by pain, the nature of which can only be inferred in 

 the case of the lower animals (not by spasms of the pectoral mus- 

 cles), and that hypertrophy of the heart is not likely to be present 

 in case of insufficiency of blood supply to its walls. 



In true angina pectoris of the horse, treatment is useless. Ab- 

 solute rest is a prime requisite, and anodynes, stimulants, heart 

 tonics, and nerve tonics are indicated. But the horse at rest, 

 with no prospect of final recovery, is simply a source of expense. 

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