CONGESTIVE HEART FAILURE AND ANGINA PECTORIS: THE THERAPEUTIC EFFECT OF THYROIDECTOMY ON PATIENTS WITHOUT CLINICAL OR PATHOLOGIC EVIDENCE OF THYROID TOXICITY

Previous studies of the velocity of the blood flow in man¹ have shown that the adequacy of a given velocity of blood flow cannot be decided in absolute terms. It can be evaluated only in relation to the metabolic demands of the particular patient. The best gage of the metabolic needs of the tissues is the basal metabolic rate. Whether or not a patient with heart disease suffers from the signs and symptoms of circulatory insufficiency depends on whether the supply of blood is adequate to the metabolic demands of the tissues. In patients with congestive heart failure and a normal basal metabolic rate, the basal velocity of the blood flow is greatly slowed.² The blood flow may be similarly slowed in patients with the low metabolic rate of myxedema,³ but such patients show no clinical symptoms or signs of congestive heart failure. In these patients, therefore,