Sept 11, 1967

Congestive Heart Failure

Author Affiliations



by Ralph M. Myerson and Bernard H. Pastor, 174 pp, with illus, $12.85, St. Louis: C. V. Mosby Co., 1967.

JAMA. 1967;201(11):897. doi:10.1001/jama.1967.03130110123058

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Like the last chapter of a tragic novel, cardiac failure cannot be fully understood without the knowledge of preceding events. As a terminal phase of most cardiac disorders, it cannot be lifted out of the general context of heart disease. A book devoted to heart-failure must touch on many aspects of heart disease and, in the process, run the risk of sacrificing depth for breadth.

This sacrifice has not been successfully avoided in Myerson and Pastor's monograph. Some subjects are given superficial treatment. In the paragraph on chemical factors in vasomotor control, we are told that "serotonin, 5-hydroxytryptophane, is a peripheral vasodilator"—the entire complex subject of serotonin effects on the circulation dismissed in one short sentence. Controversial statements are made without supporting evidence. Acetylcholine is stated to have a positive inotropic action on the ventricular myocardium, but no evidence is presented for what is, at best, a debatable concept. Potassium