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July 15, 1933


JAMA. 1933;101(3):206-207. doi:10.1001/jama.1933.27430280001012

In congestive heart failure, the venous pressure reading is of inestimable value. This determination offers a useful means of rating cardiovascular insufficiency. Under normal conditions the heart transports as much blood as comes to it, and there is merely a temporary rise of venous pressure. In cardiac decompensation, however, the load of the heart exceeds its physiologic response. It cannot convey into the arterial circulation the blood that comes to it from the venous circulation. Venous engorgement and stasis result, with a consequent failure of the ventricles. The increased burden on the heart produces cardiac dilatation with consequent heart failure. It has been shown experimentally that the decompensated heart needs more oxygen than the normal heart, whereas under the foregoing conditions its supply of oxygen is actually lessened. The coronary circulation is decreased, which further lowers cardiac efficiency. Venesection, in such instances, may prove a life-saving measure. Eyster1 states:

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