Cardiac pain. A consideration of its nosology and clinical associations

The "disorder of the breast" described by Heberden, in the light of increasing experience, has proved to be the symptomatic manifestation of many pathological states. Perpetuation of the name originally given to the condition, and the concept of angina as a clinical entity, has resulted in confusion and disagreement as to its precise meaning. It is, therefore, suggested that the term "angina pectoris" be abandoned. Correlation of clinical and pathological data has demonstrated that cardiac pain may be associated with a variety of structural and functional changes. Pain resulting from disturbances in the region of the heart is best described as cardiac pain. In making a complete cardiac diagnosis, this should be qualified by a statement as to the probable structural and functional changes with which the pain is associated. Further knowledge concerning the mechanism of pain production may point the way to a more precise terminology. The conception of pain as a symptom will make for better diagnosis, for rational therapy, and for more accurate prognosis.