Abstract
It has been said that anisocoria had been rarely observed in cardiac disease, although it had been frequently found in pulmonary disease. Anisocoria associated with angina pectoris is expected to be one of the important objective findings which represent the irritation of afferent cardiac nerve. Seven cases of cardiac patients associated with anisocoria are described in this paper. Case Number 1 was a 32 year old man diagnosed as combined valvular disease caused by the acute rheumatic fever. Two years before admission he complained of anginal pain or precordial discomfort frequently. At the time of admission he was in the state of congestive heart failure. But neither anginal attack nor anisocoria was observed. Serum examination of syphilis was negative. After the administration of digitalis and diuretics the sign of congestive heart failure improved. Thirtyfive days after the admission he complained of severe anginal pain, which radiated to the left shoulder. Precordial discomfort continued for the following two days. About 12 hours after the attack anisocoria was perceived. Besides the dilation of the left pupil, no other abnormal neurological findings were observed. Three days later anisocoria disappeared. This careful observation demonstrated a certain relationship between anginal pain and anisocoria. Dilation of the left pupil seemed to be resulted from the stimulation of the left cervical sympathetic fibers which might be irritated reflexly by the impulse from the afferent cardiac nerve. Anisocoria was also observed in case of acute attacks or anginal stages of other six cases who had myocardial infarction.
