In July 1863, Confederate General Robert E. Lee hatched an audacious plan to invade the North, defeat the Union Army, and force an end to the war – with a Confederate victory. Everything – perhaps the entire Civil War – depended on the outcome at Gettysburg.
So maybe Lee should have stayed home to recover from his heart attack.
A study from the National Institute of Health's Center for Biotechnology Information reviewed the general's medical history in 1992. Despite his relatively good medical condition from 1864 to 1867, by the end of the decade, he suffered from exertional (stable) angina – chest pain from blocked arteries caused by activity. By 1870, his angina became unstable and he died at age 63.
"It often was stated that the loss of the war broke the heart of Lee, but in view of our modern day understanding, it probably is more accurate to say that advancing coronary atherosclerosis was the culprit," the NIH said.
"Cigarettes. Cigarettes for all!"
Pericarditis is an inflammation of the membrane surrounding the heart but the NIH study refutes that diagnosis because American doctors were unfamiliar with the idea of angina. The researchers proposed instead that Lee suffered from ischemic heart disease, which would keep blood and oxygen from getting to the muscles of the heart.
His heart disease may have affected his judgement in all areas of life, which would explain some of the inexplicable and uncharacteristic decisions he ordered that day, namely Pickett's Charge.
Lee's March 1863 episode was a heart attack, not Pericarditis. As the NIH diagnosis says, the loss at Gettysburg didn't break Lee's heart, it was broken when he got there.