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A stomach cramp is a not infrequent cause of serious pain referred to the heart, and the rare condition of cardiospasm must also be remembered as a cause of pseudo-angina.

In true angina there is some condition within the heart which starts the stimulus sent to the nerve centres. In pseudo-angina the starting-point is not the heart but some peripheral or visceral nerve. The impulse passes thence to the medulla, and so reaching the sensory centres starts a feeling of pain that radiates into the chest or down the arm.

Pseudo-angina. In connexion with angina pectoris, a far more common condition must be mentioned that has now universally received the name of pseudo-angina. This includes the praecordial pains which very closely resemble those of true angina. The essential difference lies in the fact that pseudo-angina is independent of structural disease of the heart and coronary arteries.

Not infrequently, whether a patient is suffering from real angina pectoris or a pseudo-angina pectoris, the absorption of toxins irons the intestines, due to indigestion and fermentation, adds to these cardiac pains, and may even be a cause of them.

An attack of pseudo-angina may be agonizing, the pain radiating through the chest and into the left arm, but the patient does not usually assume the motionless attitude of true angina, and the duration of the seizure is usually much longer. The treatment is that of the underlying neurosis and the prognosis is a good one, sudden death not occurring.

Endocarditis Acute, simple malignant Chronic Valvular Lesions Broken compensation Cardiac drugs Diet Resort treatment Cardiac disease in children Cardiac disease in pregnancy Coronary sclerosis Angina pectoris Pseudo-angina Stokes-Adams disease Arterial hypertension Cardiovascular-renal disease Arrhythmia Auricular fibrillation Bradycardia Paroxysmal tachycardia Hyperthyroidism Toxic disturbances Physiologic hypertrophies Simple dilatation Shock Stomach dilatation Anesthesia in heart disease