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May 5, 1969

Surgery for Coronary Artery Disease

Author Affiliations

From the Department of Medicine, the Jewish Hospital of St. Louis, and Washington University School of Medicine, St. Louis.

JAMA. 1969;208(5):849-854. doi:10.1001/jama.1969.03160050103013

Dr. Julius Elson, Attending Physician, Jewish Hospital of St. Louis, and Instructor in Clinical Medicine, Washington University School of Medicine: This 67-year-old man was admitted for evaluation for coronary artery surgery because of disabling angina pectoris.

The patient was in good health until May 23, 1955, when he suffered an episode of prolonged chest pain and was hospitalized at another institution for three weeks because of an acute myocardial infarction. The clinical course was uneventful and he was discharged without congestive failure or angina pectoris. The patient returned to work and remained active and well until 1961, when he noticed the onset of typical angina when on effort; it was well-controlled by one or two nitroglycerin tablets per day. In 1963 chest pain occurred 5 to 12 times daily when less effort than before was exerted and this was still relieved by nitroglycerin. In an attempt to diminish the frequency