Manifestations Of Coronary Heart Disease Research Articles

Returning the farmer with cardiac disease to work

Farming as an occupation still requires much physical work although today the drudgery is neither necessary nor remunerative. The requirement of hard work acts as a selecting factor, discouraging the unfit from entering the vocation. The activity of farming appears to have a prophylactic effect on the manifestation of coronary heart disease. However, the nature of the farm business makes the impairment of the farmer in the acute stages of heart disease a serious threat not only to the man but also to the future of the business. The farmer commonly owns all or part of his farm; he has many alternatives which permit him to live usefully with his heart disease. These alternatives range from changing work methods, the size of business being unaltered, through obtaining more labor to retiring. The complexity of the alternatives makes decision-making difficult. However, once the acute stages of the disease are overcome, the farmer may obtain help in planning his farm from the agricultural extension service; there are also sources of credit which can provide capital for mechanization to aid in overcoming the physical impairment. The physician has a real opportunity in rehabilitation of this highly motivated group of patients. Apart from his medical skills, the physician's success will depend upon some understanding of the stresses of farm work and means for their reduction. The instructions to the farmer in the area of work must be specific. Compliance will often be better if the family is well informed. Acceptance by the community of the fact that most farmers with cardiac disease are able to work within limits is essential to satisfactory rehabilitation. Most people consider the physician as the main source of information in this area. Therefore, community education on health and disease is another responsibility of the physician trying to rehabilitate cardiac patients who are farmers.

Differential diagnosis of the pain of coronary heart disease.

Article1 February 1957DIFFERENTIAL DIAGNOSIS OF THE PAIN OF CORONARY HEART DISEASEA. CARLTON ERNSTENE, M.D., F.A.C.P.A. CARLTON ERNSTENE, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-46-2-247 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe three most common clinical manifestations of coronary heart disease are, in their order of frequency, angina pectoris, acute myocardial infarction and acute coronary failure. Each of these conditions is characterized by pain in the chest due to anoxia of one or more areas of the myocardium. The pain is similar in location in all three, and the syndromes are distinguished from one another chiefly by the length of time the distress persists and by whether the anoxia is of sufficient severity and duration to result in the death of myocardial tissue. Pain in the chest may also be caused...Bibliography1. LaDueNydickWroblewski JSIF: Serum glutamic oxalacetic transaminase as an index of acute heart muscle damage, Circulation 12: 735, 1955. Google Scholar2. ViarHarrison WNTR: Chest pain in association with pulmonary hypertension. Its similarity to the pain of coronary disease, Circulation 5: 1, 1952. CrossrefMedlineGoogle Scholar3. BlumgartSchlesingerDavis HLMJD: Studies on the relation of the clinical manifestations of angina pectoris, coronary thrombosis, and myocardial infarction to the pathologic findings with particular reference to the significance of the collateral circulation, Am. Heart J. 19: 1, 1940. CrossrefGoogle Scholar4. PrinzmetalMassumi MRA: The anterior chest wall syndrome—chest pain resembling pain of cardiac origin, J. A. M. A. 159: 177, 1955. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Cleveland, Ohio*Presented at the Thirty-seventh Annual Session of The American College of Physicians, Los Angeles, California, April 19, 1956.From the Cleveland Clinic and the Frank E. Bunts Educational Institute, Cleveland, Ohio.Requests for reprints should be addressed to A. Carlton Ernstene, M.D., The Cleveland Clinic, 2020 East Ninety-third Street, Cleveland 6, Ohio. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDie Coronarerkrankungen. Coronarinsuffizienz, Angina pectoris und Herzinfarkt 1 February 1957Volume 46, Issue 2Page: 247-254KeywordsAnginaAortaCoronary heart diseaseElectrocardiographyEmphysemaHerniaMyocardiumOsteoarthritisThoraxWalking Issue Published: 1 February 1957 PDF downloadLoading ...