Chest Pain in Association with Pulmonary Hypertension: Its Similarity to the Pain of Coronary Disease

This communication deals with a type of chest pain which is not uncommon, and which is likely to lead to an erroneous diagnosis of coronary arterial disease. The term "hypercyanotic angina," which has been applied to the syndrome in the past, is unfortunate because many of the patients are not cyanotic, and further because the physiologic mechanism of the pain, while still obscure, appears to be different from that of the pain of angina pectoris. In the patients we have observed, the one constant feature other than pain has been clinical evidence of increased pressure in the pulmonary vascular circuit. Hence, the term "pulmonary hypertensive pain" is employed, but with the reservation that more complete knowledge of the exact pathogenesis may make a different name desirable.