unlikely to ever encounter such a case as the patient would be hospitalized.
If the occlusion of the lung artery is only partial and temporary the manifestations are less
dramatic. The patient feels a constriction in the chest and breathlessness. The pulse rate
increases, there may be a temperature and there will be a dull area on the chest on percussion and
auscultation. These symptoms and signs disappear after a while as the embolus moves on.
Carcinoma of Bronchus
This is more common in men over 40. It may manifest with a cough, a deep-seated chest pain,
loss of appetite and loss of weight.
Ischaemic Heart Disease
The term ischaemic heart disease indicates myocardial damage from an insufficient coronary
blood supply. In most cases this is due to a narrowing of the coronary arteries from
atherosclerosis, but in a few cases, it may also be due to aortic valve disease, severe anaemia or
coronary embolism.
The most common cause of ischaemic heart disease is obstruction of a coronary artery by an
atheroma, which is a plaque consisting of a core rich in cholesterol and other lipids, surrounded
by fibrous tissue.
The clinical manifestations of this condition can be very varied as it can give rise to several
consequences. For example, both cardiac infarction and angina pectoris (see below) may be a
consequence of ischaemic heart disease. Other possible consequences of ischaemic heart disease
are left ventricular failure and arrhythmia.
Angina Pectoris
This is due to a recurrent spasm of a coronary artery. It is more common in men over 50. The
chest pain is elicited by exercise, exposure to cold, a heavy meal, or excitement.
The main symptom is a recurrent chest pain which comes in bouts. It can vary in intensity from a
slight prickling sensation to an intense stabbing pain. The pain may radiate to the shoulder or left
arm. It is accompanied by a feeling of constriction in the chest, nausea or vomiting. The person
becomes pale and motionless and the blood pressure is raised. The cardiac rhythm is not
disturbed.
Myocardial Infarction
Myocardial infarction is usually due to coronary thrombosis or occlusion of a coronary artery by