Walter W. Hamburger

The diagnostic value of epinephrine in angina pectoris

Abstract Epinephrine as a test for angina pectoris was found to be unreliable in regard to both the symptoms produced and the electrocardiographic changes. This unreliability makes the test of little value, particularly in view of the severe reactions sometimes encountered.

Studies in thyroid heart disease

Attention is called to the association of angina pectoris and hyperthyroidism. We believe that thyroidectomy is not contraindicated in the presence of angina pectoris, and have found that in the majority of cases relief of the anginal symptoms followed the use of iodine and thyroidectomy. The exact mechanism of the production of angina pectoris in hyperthyroidism and the interrelationship between the two conditions are not clearly understood at this time. We believe, however, that in such patients the underlying groundwork for the anginal syndrome already exists, such as coronary sclerosis with or without occlusion, myocardial fibrosis, aortitis, ete., and that the toxic thyroid (hyperthyroidism) is the additional burden which precipitates an anginal attack.Abstract Attention is called to the association of angina pectoris and hyperthyroidism. We believe that thyroidectomy is not contraindicated in the presence of angina pectoris, and have found that in the majority of cases relief of the anginal symptoms followed the use of iodine and thyroidectomy. The exact mechanism of the production of angina pectoris in hyperthyroidism and the interrelationship between the two conditions are not clearly understood at this time. We believe, however, that in such patients the underlying groundwork for the anginal syndrome already exists, such as coronary sclerosis with or without occlusion, myocardial fibrosis, aortitis, ete., and that the toxic thyroid (hyperthyroidism) is the additional burden which precipitates an anginal attack.

The association of angina pectoris and hyperthyroidism

Abstract 1. 1. Six cases, five women and one man, of associated angina pectoris and hyperthyroidism are included in our series. 2. 2. One case is reported with autopsy findings. 3. 3. The youngest individual in our series was forty-nine years, the oldest sixty-two, the average age for the six cases being fifty-six years. 4. 4. The predominance of women in our series may be only a coincidence or it may suggest that, in hyperthyroidism, angina is more likely to occur in women than in men. 5. 5. Of the five cases operated upon, four have remained free of anginal pain to date, one patient continued to have cardiac pains and died a month later. 6. 6. The occurrence of angina pectoris in hyperthyroidism is not common but probably is not quite so rare as heretofore thought. 7. 7. As to the pathogenesis of angina pectoris in hyperthyroidism, we offer the suggestion that its occurrence is evidence of ischemia or anemia of the heart muscle due either to anemia, coronary sclerosis, or occlusion, or to some other factor or factors interfering with an adequate coronary blood supply to the actively working thyrotoxic heart. 8. 8. The majority of cases of angina pectoris occurring in hyperthyroidism belong to the class of secondary anginas as described by Mackenzie. 9. 9. Cases of angina pectoris associated with hyperthyroidism may properly be called “thyroid angina” just as cases of tobacco angina, angina of anemia, etc., are now recognized. In this connection it is suggested that in certain cases of angina occurring in women approaching middle age the possibility of an underlying or an associated hyperthyroidism be considered, and conversely that in hyperthyroidism occurring in such patients the possibility of an associated angina be investigated.