Refractory Chest Pain or Treating Cardiologist's Bane: A Case Report

Microvascular angina is caused by dysfunction of small-resistance coronary arteries (< 500 µm) and is of heterogenous origin. The major epicardial coronaries are normal and commonly seen in women. Prognosis is variable, with disabling angina in many patients and can be a cause of mortality, especially in those who are refractory to treatment. In this background, we present a case of 56-year-old post valve replacement with normally functioning aortic valve and recurrent episodes of microvascular angina. The patient had normal epicardial coronaries. She had recurrent episodes of angina refractory to various antianginals associated with hemodynamic instability. Microvascular angina can curtail routine activity, frequent hospitalization, and repeated noninvasive and invasive investigations. Thus, it is a high social and economical disease, especially pertinent to women.

The Metronome of Consciousness

Samuel Beckett's 1966 work is generally read as a prose dramatization of the experience of a consciousness near to death, and the word 'ping' itself is taken to be non-referential. This paper examines Beckett's use of 'ping' as one of a constellation of terms which, when taken together with his frequent hospitalization in the years leading up to 1966, suggest a directly referential reading.