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This article presents selected aspects of the discussion on the cognitive status of explanatory hypotheses that were formulated at the end of the 20th century in cardiology in relation to abnormal phenomena observed in clinical practice. The aim is to provide a critical analysis of the validation process for such hypotheses. We are going to point out how their formulation contributed to the creation of three dimensions of the dispute: methodological, ontological and pragmatic. We will argue for the two theses. Firstly, due to the non-falsifiability of formulated explanatory hypotheses an instrumental attitude was adopted. Secondly, it will be demonstrated that adopted cognitive attitudes influenced the evaluation of clinical situations, and as a result, they had an impact on the decision-making process.
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