The significance of adventitial infiltrations in coronary atherosclerosis.

There are a large number of deaths from coronary disease in which a necropsy examination generally gives less evidence of the exact cause of death than the clinical findings. In the absence of fatal structural lesions, acute coronary deaths have been attributed to disturbances of function such as inhibition, arrhythmias, and coronary spasm; but the problem has been one ofdebate rather than observation. Albutt rejected the spasm theory in no uncertain terms, saying " The truth is, spasm of the coronary arteries is a nosologist's conceit to explain puzzles of his own making." The object of this investigation was to attempt to establish some correlation between the histological features of the coronary arteries and the mode of dying. Attention was directed to the changes in the adventitia and in particular to the frequent occurrence therein of discrete foci of inflammatory cells. The incidence of these lesions is analysed, the appearances described, and their significance discussed.