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It is a disturbance of the heart which most frequently attacks men, probably more than three fourths of all cases of this disease occurring in men; in a large majority of the cases the coronary arteries are diseased. Various pains which are not true angina pectoris occur in the left side of the chest; these have been called pseudo-anginas. They will be referred to later.

The effects of caffein and tobacco on the heart will be considered later when toxic disturbances are under discussion. The above-mentioned causes of pseudo-anginas have only to be named to indicate the treatment which will prevent the pain attacks.

Other frequent causes of more or less disturbance of the heart's action, often accompanied by pain, are overexertion, worry and mental anxiety, and intestinal toxemias due to too much protein or disturbed protein digestion. Frequent causes are tobacco, and the overuse of tea and coffee. Many a patient's pseudo-anginas are corrected by stopping tea and coffee.

In other words, the interpretation of these pseudo-anginas means a careful diagnosis of the condition, and, as previously stated, not only must the above- named causes be excluded, but also the reverse must be remembered: that many disturbances treated as other conditions really are due to cardiac weakness. The diagnosis of a real angina pectoris from a false angina may not be difficult.