Angina Pectoris and Cardiac Infarction From Trauma or Unusual Effort

Can a nonpenetrating injury to the chest or severe bodily effort directly provoke cardiac infarction or lead to changes in the heart that give rise to the syndrome of angina pectoris? This question, arising so frequently in connection with claims under workmen's compensation acts, has not yet been satisfactorily answered. The preponderant opinion at present seems to be that trauma and effort so rarely precede the onset of coronary thrombosis that their association is just coincidental. This thesis has been particularly elaborated by Master and his associates. 1 They have analyzed the events attending 530 attacks of coronary thrombosis. They find that 22 per cent of attacks occur when the patient is at rest, 20 per cent while he is asleep, 18 per cent while he is walking, 14 per cent during mild activity and 5 per cent during moderate activity. They point out that since half of the day