CORONARY HEART DISEASE IN THE PRESENCE OF PULMONARY DISEASE

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Abstract
The problem of the coexistence of coronary heart disease in the presence of pulmonary disease was studied by reviewing the clinical features, ecg patterns and necropsy findings in 69 cases of severe pulmonary disease (miners and ex-miners). Thirty-two had clinical and necropsy evidence of coronary heart disease, 26 had doubtful evidence of coronary heart disease which was not confirmed at necropsy, and 11 patients had significant coronary artery disease that had not been diagnosed during life. The difficulties lie in differentiating cardiac pain from pleuro-pulmonary pain, in recognizing other causes of left ventricular enlargement such as aortic stenosis and myocardial fibrosis, and in identifying the causes of varying degrees of heart block.