March 15, 1965

The Changing Concept of Coronary Artery DiseaseA review of the problems and approaches to therapy for coronary arteriosclerotic heart disease.

JAMA. 1965;191(11):31-32. doi:10.1001/jama.1965.03080110099059

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The general view of coronary arteriosclerotic heart disease as a simple progressive narrowing of the coronary artery with final closure due to thrombosis is no longer tenable, Herrman L. Blumgart, MD, professor of medicine emeritus, Harvard Medical School, said.

"One must instead, consider that the final effect on the myocardium is the result of two opposing factors: (1) the reduction of blood flow due to narrowing and complete occlusion and (2) the compensatory development of larger than normal collateral channels which offset the dire consequences of narrowing or occlusion."

It is obviously of considerable theoretical and practical importance to know both the conditions which favor the development of the larger compensatory anastomotic channels and the length of time necessary for their establishment, Blumgart told fellows and guests of the American College of Cardiology at the ACC 14th annual meeting held Feb 18-21 in Boston.

In approximately 40% of patients without

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