Heart Disease In Persons Research Articles

Two-step electrocardiogram for chest pain reported on multiphasic screening

Among 264 consecutive persons (142 men, 122 women) greater than or equal to 35 years of age presenting for multiphasic screening examination, 85 (54 men, 31 women) reported chest pain. In most, the pain was not typical of coronary artery disease. The two-step exercise electrocardiogram (ECG) was positive (greater than or equal to 0.5-mm ischemic ST depression) in 21% of the patients who reported pain and in 19.5% of 66 randomly selected, similarly examined controls without chest pain (36 men, 30 women) (difference not significant). Females with positive ECGs (5-mm or 1-mm depression) predominated over males greater than or equal to 5:1 in the chest pain group and greater than 3:1 in controls. This study indicates that the routine two-step exercise ECG is not helpful in detecting ischemic heart disease in persons reporting chest pain during their multiphasic screening examination.

The medical ecology of public safety. I. Sudden death due to coronary heart disease

A total of 1,348 instances of sudden and unexpected death due to coronary heart disease in persons 65 years of age and under in Dade County, Florida, was studied in order to determine the hazard to the general population created by these sudden deaths. Only 348 (25.8 per cent) of these patients had had known coronary heart disease at the time of their death. There were 451 (33.4 per cent) instances of sudden death in patients with undiagnosed cardiovascular symptoms, and 529 (40.8 per cent) cases in which there were no premonitory symptoms at all. There were 122 persons (9.1 per cent of the total) whose occupations were potentially hazardous to the public. Twentyeight of these persons were involved in their work at the time of their death, with no serious accidents occurring as a result of their deaths. One hundred and one persons (7.5 per cent) were involved in hazardous terminal activities at the time of their death; 52 of these were driving automobiles. Again, no serious damage or injuries occurred. The conclusion is that, with certain specific exceptions, there is at the present time no justification in interfering with the occupations or avocations of coronary patients on the basis of the hazard of sudden death which they present to the general population. Activities and work for these persons are best individualized for each patient on the basis of his functional capacity and symptomatology.

Deaths from coronary heart disease in persons fifty years of age and younger. A community-wide study.

THIS study was undertaken to describe, epidemiologically, fatal coronary heart disease in persons fifty years of age and younger during a one-year period in an urban-suburban community of approximately 1,000,000 persons. The Seattle–King County Department of Public Health served as the operational base of this investigation. The trend of occurrence of coronary heart disease in relation to total mortality in this community is shown in Table 1. The data for this table were compiled by Ravenholt,1 who recoded original certificates of death for the years shown to fit as closely as possible the 1955 International List of Diseases and Causes of . . .

The exercise electrocardiogram: An aid in the diagnosis of arteriosclerotic heart disease in persons exhibiting abnormally large Q 3 waves

Twenty persons with the single electrocardiographic abnormality of a large Q wave in lead III were studied by the exercise electrocardiogram. In five persons who had a previous myocardial infarction the exercise electrocardiogram was “positive” and remained so through a minimum period of one year after recovery. In the others who had no clinical evidence of previous infarction the exercise electrocardiogram was “negative” or unaltered. The significance of these results is discussed in relation to the diagnosis of arteriosclerotic heart disease.

RATIO OF CARDIOVASCULAR MALFORMATIONS TO OTHER TYPES OF HEART DISEASE IN CHILDREN

This study concerns the incidence of congenital heart disease in relation to that of all heart disease as observed at the Children's Memorial Hospital in Chicago. In 1937 Roberts1stated that there was no trustworthy estimation of the incidence of congenital heart disease. White2tabulated nineteen reports on the subject from various parts of the world, including the United States, England, South Africa and Ceylon, and the rates (relative to all heart disease) varied from 0 to 5.5 per cent. These studies obviously were not directed at children and presumably included all age groups. Levine3stated that the incidence of congenital heart disease is probably not more than 1 to 2 per cent of all heart disease in persons over 12 years of age and added that the figure will be much greater for persons under that age. Most of the recent investigations concerning the topic have

THE "DOCTOR'S HEART"

The extensive propaganda for periodic health examinations and the alarming increase in the number of sudden deaths from heart disease in persons apparently enjoying good health have brought unconsciously, perhaps, into the busy life of the average physician a feeling akin to apprehension when the problems of middle age are considered. Whether there is an actual increase in heart disease or whether the increase is only apparent has been the point of discussion in a recent editorial inThe Journal; 1 without doubt, however, the physician is becoming more aware and increasingly cognizant of the number of cardiovascular deaths. While the question may be of general interest, it becomes more sharply focused when the number of physicians meeting cardiovascular deaths is considered. One has only to scan the death columns in the current medical journals both in this country and abroad to realize the significance and truth of this observation,