Two Cases of Temporal Arteritis: One with Angina of Effort.

Temporal arteritis was first described as a separate syndrome by Horton, Magath, and Brown in 1932. The clinical features of headache associated with inflamed and tender temporal arteries, the histological appeafance of excised portions of these arteries, and the apparently self-limited course of the disease led them to suggest that this was a new clinical entity. Since then about forty cases have been recorded and in an excellent resume of these, which included seven of their own, Cooke, Cloake, Govan, and Colbeck (1946) have produced clinical and pathological evidence to support their view that temporal arteritis is a generalized vascular disease that is distinct clinically and pathologically from thrombo-angiitis obliterans and periarteritis nodosa. They point out that the characteristic clinical features are anorexia, loss of weight, joint and muscle pains, pyrexia, painful arterial thrombosis, and severe headaches occurring in elderly patients; and that at least half so far reported have had visual disturbances leading in many instances to complete loss of sight. In two cases a characteristic histological picture was noted in all the main arteries of the body including the aorta and coronaries. Since 1931 I have had three patients with the disease, under observation. Details of the first were published previously in a paper by Jennings (1938). Of the other two described here, one suffered from severe angina of effort in addition to characteristic signs and symptoms, and died in a typical attack of coronary thrombosis. In other respects all three were remarkably similar.