Variations on a theme from Heberden: symptoms in angina pectoris1

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Typical angina pectoris is a distress, other than dyspnea, located in the upper half of the body precipitated by walking and relieved promptly by rest. Arteriographie evidence of severe coronary disease is almost always found in patients with typical symptoms. Although the diagnosis of angina pectoris may be simple, variations in the character and location of the distress, precipitating factors, accompanying symptoms, and means of obtaining relief may cause confusion. Awareness of these variations increases diagnostic precision. Certain symptoms are warnings that the discomfort may not be of cardiac origin. Some noncardiac diseases are more frequent in patients who have angina pectoris, especially angina due to coronary spasm.



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