ABNORMALITIES IN THE PULMONARY ARTERIOLES IN SOME CASES OF CORONARY ARTERY DISEASE BY

In 1960 we published a method for assessing the volume of the vascular bed in the peripheral parts of cadaveric lungs (James et al., 1960). We have since used the method in studying the lungs from many cases of chronic cardiac and pulmonary disease. When examining the lungs from patients who had had coronary artery disease we noticed that the severity of the pulmonary arteriolar lesions varied with the clinical history. The purpose of this paper is to demonstrate the relationship between the clinical syndromes and the abnormalities in the pulmonary arteriolar bed. We were able to study the lungs from two different groups of patients with coronary artery disease. Nine had had prolonged invalidism with many hospital admissions for left ventricular failure or chronic dyspncea. Eleven others had had no invalidism and had died suddenly apparently while in good health. METHOD At necropsy the main pulmonary artery of one lung was injected with a radiopaque medium containing a known concentration of radio-iodinated serum albumin. It was then fixed and dis-tended by introducing industrial methylated spirit into the main bronchus. The specimen was then radiographed and blocks were taken for histology. Pieces of about 40 ml. in volume were then cu