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The Anatomic Pathologic Problem

HERRMAN L. BLUMGART, M.D.; PAUL M. ZOLL, M.D.; GEORGE S. KURLAND, M.D.

AMA Arch Intern Med. 1959;104(6):862-869.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The Central Problem

The therapeutic problem in coronary artery disease is created by the existence of structural coronary narrowing or complete occlusion causing diminished coronary blood flow. The reestablishment of a satisfactory blood supply then becomes the central objecttive.

The Nature of the Occlusion

Excluding the more unusual causes, such as embolism, syphilitic narrowing of the coronary ostia, necrotizing arteritis, or calcific aortic stenosis impinging on the ostia, one deals with coronary atherosclerosis as the causative process in more than 90% of patients with angina pectoris or acute myocardial infarction. An effective therapeutic approach must be based on knowledge of the anatomic changes and of the pathologic physiology of the atherosclerotic process.

The Anatomic Characteristics of Coronary Atherosclerosis.

—The obstructing atherosclerotic lesions are arterial, not venous, and reside in the main stems and primary branches. They are almost entirely epicardial. The highest incidence of occlusions is not directly at the . . . [Full Text PDF of this Article]

Author Affiliations
Boston

From the Medical Research Department, Yamins Research Laboratories, Beth Israel Hospital, and the Department of Medicine, Harvard Medical School.

Footnotes
Received for publication June 23, 1959.

These investigations were aided by the Sydney Green Heart Research Fund and by grants H-4151 and H-1120 from the U.S. Public Health Service.

Read in the Symposium on Direct Relief of Coronary Occlusion before the Section on Experimental Medicine at the 108th Annual Meeting of the American Medical Association, Atlantic City, June 9, 1959.

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