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August 4, 1945


JAMA. 1945;128(14):1016-1018. doi:10.1001/jama.1945.02860310030007

Whether digitalis is of benefit in myocardial infraction is not generally agreed on. Many cardiologists believe that it should be used for congestive failure associated with myocardial infarction and especially if the congestive failure occurs with auricular fibrillation, but others have expressed doubt as to its ultimate value. Levine1 believes "it is more likely to do harm than good." Conner2 says that "among clinicians, the opinion is almost always... held that digitalis is dangerous." Fishberg3 attributes much of the disrepute that digitalis suffers in myocardial infarction to its use in the early stages of shock rather than during congestive failure. He emphasizes that the theoretical dangers of digitalis in myocardial infarction are the production of (1) ventricular fibrillation, (2) rupture of the heart, (3) embolization, the latter two, he believes, being due to the more powerful systole, or (4) coronary constriction. He states, however, that whether or