W. Williams describes a case of illness in the horse to which he gives
this name. When standing idle he had twitchings of the pectoral muscles,
and when exercised these and adjacent muscles became violently
convulsed, the left fore limb being alternately fixed by spasm, and
paralyzed so that it was useless and the animal fell if compelled to
move. There was “venous pulse, great irregularity of the heart’s action,
a loud cooing or blowing sound and strong impulse indicative of
hypertrophy and a want of correspondence between the cardiac energy and
feeble pulse.” It was unfortunate that the murmur was not associated by
the observer with a particular heart sound, and with the right or left
side of the heart, and that hypertrophy was not diagnosed by percussion,
since the case can be of little value as it stands.
Breast pang is usually associated with some disease of the heart:
obstruction (usually calcification) of the coronary arteries,
insufficiency of the aortic valves, calcareous degeneration of the
aorta, aortic aneurism, or fatty degeneration of the heart. Loomis,
basing his view on dissections made by himself and others, resolves all
of these into concurrent ischæmia of the heart, the circulation in the
coronary arteries being seriously interfered with.
“That the sudden withdrawal of a supply of blood to a part may occasion
neuralgia is shown by the intense pain in the limb which directly
follows embolism of the femoral artery. Moreover general anæmia, as is
well known, favors the recurrence of neuralgia in various situations.”
Inability of the heart to propel the blood is to be explained in the
same way.
The difficulty of endorsing Williams’ diagnosis lies in the fact that
the disease, so far as it is a distinct disease, is functional and
manifested by pain, the nature of which can only be inferred in the case
of the lower animals (not by spasms of the pectoral muscles), and that
hypertrophy of the heart is not likely to be present in case of
insufficiency of blood supply to its walls.
In true angina pectoris of the horse, treatment is useless. Absolute
rest is a prime requisite, and anodynes, stimulants, heart tonics, and
nerve tonics are indicated. But the horse at rest with no prospect of
final recovery is simply a source of expense.