Coronary Disease: A Pathological Study

Since the diagnosis and management of coronary disease depend largely upon premises derived from pathological (and clinico-pathological) studies, the methods used in these types of investigation obviously require careful scrutiny. The focal point of such work is the detailed examination of the heart at necropsy, and the more accurate the methods used for this purpose, the greater the number of lesions revealed in the coronary arteries and myocardium. In previous work the introduction of new technical methods for studying either arterial or myocardial lesions has led to concentration upon the type of lesion that the new technique demonstrated, often to the comparative neglect of other lesions. Thus the detailed methods of examining the myocardium employed by Kossmann and de la Chappelle (1938), Lowe (1941) and Myers et al. (1947) were not combined with equally satisfactory methods of examining the coronary arteries, and the very careful study of the coronary arteries made by Blumgart et al. (1940) does not appear to have been combined with an equally comprehensive study of the myocardium. It therefore seemed worthwhile to reinvestigate the relationship between coronary artery occlusion and myocardial infarction by the best available techniques for the post-mortem study of both arterial and myocardial lesions.