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The Cincinnati Lancet-Clinic , official journal of the Cincinnati Academy of Medicine [September 18, 1897] described a typical case: There was a slight intermission of the pulse-beat about every thirty beats, which I attributed to a nervous condition superinduced by the excessive use of tobacco, as my patient had been some five years ago an inveterate smoker and chewera typical case of tobacco heart. Far from being limited to irregular heartbeats, tobacco heart was often fatal

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PMCID: PMC2928253