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October 11, 1965

The Physician and Postmyocardial Infarction Invalidism

Author Affiliations

From the departments of medicine (Drs. Klein and Bogdonoff), sociology (Dr. Dean), and psychiatry (Dr. Dean and Mr. Willson), Duke University, Durham, NC.

JAMA. 1965;194(2):143-148. doi:10.1001/jama.1965.03090150035009

A study of 20 male survivors of myocardial infarction confirmed a clinical impression that moderate to severe invalidism often occurs in the absence of definable physical residuals of the infarction. The cultural meaning of the heart attack was found to be prominently concerned with fear of sudden death and fear of physical activity. A failure in the revision of concepts derived from the acute phase of the infarction was observed in the invalid patients and their spouses. Physician uncertainty regarding the source of somatic symptoms in invalidism was observed to exert both a delay in the recognition of the syndrome and a perpetuating effect.