Contributory Causes of Coronary Thrombosis

If the prophylaxis of coronary thrombosis is possible in a practical way, it must be based not only on an understanding of basic conditions, such as atherosclerosis, but also on a recognition of, first, the individual liable to an attack, and, secondly, exciting or precipitating factors. In considering susceptibility, the presence of peripheral arteriosclerosis forms merely a general background and even the now possible x-ray visualization of advanced coronary changes is of but little practical help when it is realized that even then the vessel may be patent or, for that matter, that total obliteration, if gradual, may be symptomless.1Characteristic electrocardiographic changes occur after the occlusion, and the term "arteriosclerotic heart disease" is too inclusive and inaccurate. That there are anticipatory symptoms and signs is suggested by the following statistics of cases treated at the Boston City Hospital and supplemented by records from my personal practice. Obviously, many