Noncoronary Factors in the Anginal Syndrome

Of 253 consecutive subjects examined prospectively for gallbladder disease, hiatus hernia and cervical-spine disease during hospitalization for coronary angiographic studies, 170 had all three examinations and formed the major subgroup for analysis. There was no significant increase in the prevalence of any of these disorders either in the coronary patients with prandial angina or in those with nocturnal chest pain. Fifty-one subjects exhibiting classic angina pectoris but with normal coronary arteriograms were similarly studied. No differences were found in the prevalence of gallbladder disease, hiatus hernia or cervical-spine disease in this group. The noncardiac factors mentioned showed no consistent association with coronary heart disease, nor did they appear to contribute significantly to the genesis of prandial or nocturnal angina or to the syndrome of angina pectoris with normal coronary arteriograms.