Much experimental and pathologic evidence has accumulated to indicate that the pain of angina pectoris is due to disturbance of the coronary circulation. The ideal therapeutic measure, then, would be one that insures at all times an adequate flow through the coronary arteries. Of the various drugs used in the treatment of this disease, those which are known to dilate the coronary arteries have received the widest acceptance. For relief from the attack, the nitrites are invaluable, not only because they reduce the systemic blood pressure and thus relieve in part the burden imposed on the heart muscle, but also because in all probability they decrease myocardial ischemia. Unfortunately, their effect is transitory. For the prevention of attacks, another class of drugs which act in much the same manner, namely, the purine derivatives (theobromine, theophylline, etc.) have proved of value. However, these drugs fall short of the ideal because they
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