Short-Circuited Heart

An agonizing stab in the shoulder, a strangling sensation in the throat, lightning pains down the left arm, a drenching sweat, a cold grey face--over it all an "indescribable feeling of anguish and a sense of imminent dissolution angor animi." This is the classic picture of the dread angina pectoris (heart attack). Rapidly on the increase, angina pectoris (usually connected with diseases of the heart's arteries) claims over 10,000 victims in the U. S. every year, mostly middle-aged professional men (doctors are especially vulnerable) who work, eat, smoke, drink too hard.

About the immediate cause of angina, doctors know practically nothing. They suspect that the violent pain arises from some kink in the nervous system. Standard treatment is rest, easy living. Anything may bring on an attack: anger, bad news, indigestion, physical strain, and each attack may be the last. A victim may live several decades, may die in an hour. To ease their agonizing pain, most sufferers carry a supply of tiny nitroglycerin tablets in their pockets.

In addition to experimenting with alleviating drugs, doctors have long plotted various surgical operations to combat angina attacks, but they have all fallen short of the mark.

Last week in the Journal of the American Medical Association, Dr. Rupert Brandon Raney of the University of Southern California's medical school reported "a hitherto undescribed surgical procedure relieving attacks of angina pectoris." Eleven patients, said Dr. Raney, underwent this remarkable operation. There were "no deaths, and all ... obtained complete relief . . . from desperate attacks" sometimes occurring as often as ten times a day.

Scene of Dr. Raney's operation is the sympathetic nervous system, an intricate barbwire fence of delicate nerves which control such involuntary functions as digesting, blushing, sweating, weeping, vomiting. Held in dynamic balance by the restraining influence of the "parasympathetic nervous system," the sympathetic system steams up when the body signals full speed ahead. During an attack of angina, a patient shows all the outward signs of "sympathetic overactivity" except one. He perspires, his stomach expands, his heart throbs in violent tempo. But for some reason his coronary blood vessels, instead of expanding, contract. In this perverse, mysterious contraction, believes Dr. Raney, lies the key to the secret of angina pectoris.

Purpose of his operation is to prevent this "reverse action" of the sympathetic system, and short-circuit erratic nerve impulses rushing to the heart. After exhaustive study, and drafting of innumerable blueprints, he decided to cut through the third, fourth and fifth ribs close to the spinal column, snip free and short-circuit the four nerves of the sympathetic system (between the second and fifth vertebrae) which lead directly to the heart. With exquisite care Dr. Raney avoided damaging other surrounding tissues, left enough nerves intact so that the patient could feel the "warning signal" of angina. Thus, although free of pain, he can still take proper precautions to prolong his life.

The new operation, Dr. Raney explained last week, does not remove the underlying causes of angina. There may be many victims whose hearts are too weak to withstand the shock of the merciful knife.

This file is automatically generated by a robot program, so reader's discretion is required.