Coronary Thrombosis Without Pain: Its Incidence and Pathology

There is a syndrome that is not associated with angina which may follow coronary thrombosis more frequently than has generally been reported. It is characterized by the abrupt onset of dyspnea, which may be paroxysmal or continuous and is unprovoked by exertion; and by shock, lowered blood pressure, disordered or weakened heart action, fever, leukocytosis, pericardial friction or embolic complications. Death may ensue in a few hours or days from ventricular fibrillation or rupture. There may be a partial recovery, after a long convalescence, which, usually in less than two years, is followed by an intractable congestive heart failure and death. Aubertin and Lereboullet1have reported a series of cases of coronary thrombosis in which this syndrome was present in about 20 per cent. and the anginal syndrome in about 80. In a review of the records of patients at the Alexian Brothers' Hospital, Chicago, in whom a diagnosis