Arthur B. French, MD
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To the Editors: The article by Ryan and colleagues (1) calls to mind the occasional occurrence of high substernal chest pain, clearly related to exercise and relieved promptly by nitroglycerine in patients who also have gallstones. In some patients, removal of the gallstones is followed by disappearance of the angina. The late Dr. Chester Jones at Massachusetts General Hospital, who may have been the first to note this phenomenon, proposed that an overflow of autonomic nervous stimuli from the gallbladder raised the level of autonomic activity in the coronary vessels. Consequently, a smaller exercise stimulus would be needed to exceed
French AB. Gallbladder Disease and Angina Pectoris. Ann Intern Med. ;117:172. doi: 10.7326/0003-4819-117-2-172_1
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Published: Ann Intern Med. 1992;117(2):172.
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