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SURGICAL AND ANESTHETIC RISK IN CARDIAC DISEASE

J. HICKMAN, M.D.; H. LIVINGSTONE, M.D.; M. E. DAVIES, M.D.
Arch Surg. 1935;31(6):917-936. doi:10.1001/archsurg.1935.01180180069003.
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The diversity of opinion in regard to whether or not patients with cardiac disease are good risks for surgical procedures or anesthesia has prompted the present study of the postoperative course in 336 patients with this disease who came to the operating room during a two year period.

In medical textbooks the following statements appear: "Serious uncompensated valvular disease of the heart is a contraindication to general anesthesia."1 "If loss of compensation is present . . . pulmonary anesthetics should be avoided and local or spinal anesthesia used."2 "General anesthesia is contraindicated in patients with grave cardiac or kidney disease."3

Several authors, including Harvey,4 who wrote an excellent article on the subject, have studied the cardiac reserve in cases of various types of cardiac lesions and advise as to diagnosis and treatment. No attempt will be made in this paper to elaborate on this phase of cardiac disease.

Necropsy

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