ABSTRACT
Six weeks after acute myocardial infarction, 303 men were randomly divided into exercise and control groups. The exercise group attended the hospital gymnasium twice weekly for a three-month supervised exercise course. Both groups were exercise tested before and after the course and at subsequent follow-up. The exercise group increased their physical fitness greatly compared with the control group. Eight per cent of the exercise group died during the period of follow-up, compared with 14 per cent of the control group; this difference is not significant. There was an apparent improvement in mortality in those with inferior MI who completed the exercise course, which was not seen in those with MI in other sites. For many patients after MI progressive exercise is safe, improves physical fitness and may reduce mortality for those after inferior MI.
Subject(s)
Myocardial Infarction/rehabilitation , Physical Exertion , Clinical Trials as Topic , Humans , Male , Middle Aged , Myocardial Infarction/diagnosis , Myocardial Infarction/mortality , Physical FitnessSubject(s)
Coronary Disease/rehabilitation , Morale , Physical Exertion , Coronary Disease/psychology , Humans , Male , Middle AgedABSTRACT
During a study investigating physiological and other effects of an exercise programme for coronary patients, a questionnaire was administered. Preliminary analysis had suggested some improvement in the patients' morale, but in view of the possible relevance of a number of psychological variables it was decided to carry out further analysis on the available data. The coefficient of discrimination was computed for 32 patients. For 19 patients correlations were computed between scores on subjective fitness, symptoms, anxiety, interest in sex, if at work, age, weight, and workload achieved at a given heart rate. The questionnaire appeared to have satisfactorily high internal and external validity. Patients with a high 'morale' score tended to achieve a greater increase in workload over the course. Although cause and effect cannot be unequivocally assigned, the association is felt to be important, and research is continuing.
Subject(s)
Exercise Therapy/psychology , Myocardial Infarction/rehabilitation , Anxiety/etiology , Body Weight , Humans , Male , Morale , Physical Fitness , Pilot Projects , Self-Assessment , Social AdjustmentABSTRACT
A patient with long-standing seropositive erosive rheumatoid arthritis developed a pericardial effusion with chronic cardiac tamponade. He had evidence of conducting system disease and developed heart block. He was successfully treated by pericardiectomy and implantation of a demand pacemaker.
Subject(s)
Arthritis, Rheumatoid/complications , Heart Block/therapy , Pacemaker, Artificial , Pericardial Effusion/surgery , Cardiac Tamponade/surgery , Heart Block/complications , Humans , Male , Middle Aged , Pericardial Effusion/complications , Pericardium/surgeryABSTRACT
Two hundred and seventy-one (76%) out of 358 survivors of infarction were discharged by the eighth hospital day, and 251 (93%) of them survived to six weeks after discharge. Six of the 20 patients who died between discharge and six weeks did so after readmission and 14 died as outpatients. All these patients who died at home had transmural infarction and four had diabetes. In inpatients successful resuscitation occurred mainly within the first 48 hours, with only three successful long-term results from all the patients who suffered arrest later. This suggests that more prolonged inpatient care would not have reduced the late mortality. These figures justify continuing with an early discharge policy for most patients, but coronary care should probably be more prolonged for patients with diabetes.
