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April 9, 1973

Atherosclerosis and Coronary Heart Disease

Author Affiliations

Tulane University New Orleans

JAMA. 1973;224(2):251. doi:10.1001/jama.1973.03220150059035

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A good deal of practical as well as highly technical information makes Atherosclerosis and Coronary Heart Disease interesting and, at times, fascinating reading. In 51 short (from three to seven pages) but well-documented essays, its contributors touch on topics that range from the determinants of myocardial oxygen consumption and lactic acid accumulation to the surgical management of coronary insufficiency (artery-vein grafting and correcting structural defects) and the makeup of the coronary care unit.

Cardiac arrhythmias develop in about 90% of persons suffering acute myocardial infarction, according to Dreifus. He comments on the potent, sometimes life-saving, inotropic and antifibrillatory actions of bretylium tosylate and discusses the effects on cardiac automaticity and conduction of the other agents used to control the tachyarrhythmias. And for the bradyarrhythmias that may precede ventricular fibrillation, he recommends artificial cardiac pacing.

Knoebel, Konecke, and Fisch note that increasing the heart rate (electrical overdrive) may also control a