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ARTICLE |

Our Changing Cardiovascular Attitudes Toward Major Surgery:  Two Hundred Four Cases of Major Surgery Reviewed

EDWARD I. MELICH, M.D.
AMA Arch Surg. 1959;78(2):340-352. doi:10.1001/archsurg.1959.04320020162025.
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A Review—Attitudes and Aspects  Often in the practice of medicine the internist or cardiologist may be called upon to support or share with the surgeon the evaluation of the preoperative cardiac fitness of the patient undergoing an indicated surgical procedure.No doubt, following such medical clearance, the internist has at times indulged in self-interrogation concerning the patient's chances of survival. Does the internist's responsibility hold for the period of the actual surgery, or 4, 12, or 24 hours, or a week, or a month after operation? Were the conclusions for clearance based on clinical experience inexpressible by words or on criteria of a standard text, or were they based on what may be designated as applied science of medicine, using tools—blood pressure apparatus, electrocardiograph, ballistocardiograph, etc.?Frequently, in the course of history taking to evaluate the functional capacity of the heart, the patient would be asked how far he

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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