Highlights the diagnostic challenges of identifying co-existent coronary heart disease in patients with pulmonary disease.
In the course pf our studies of pulmonary heart disease we have been impressed by the fre- quent co-existence of coronary heart disease noted at necropsy but less frequently recognized during life. Pulmonary disease even before the advent of heart failure, was readily recognized by its symptoms of dyspncea and cough and by its radiological signs. The co-existent coronary heart disease was often symptomless, or if pain was present it required differentiating from pleuropulmonary pain. Radiology was able to help only by showing an enlarged left ventricle in some of the cases. It seemed that electrocardiography would be the best examination to reveal the presence of the coronary heart disease with pulmonary disease, but consideration of the electro- cardiographic signs of both conditions immediately revealed difficulties of interpretation.
A. J. Thomas (1958) studied this question.