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Albert Salisbury Hyman, M.D.
JAMA. 1955;158(2):139. doi:10.1001/jama.1955.02960020045016.
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To the Editor:—  Electrocardiographic examination before and after exercise is now a standard procedure in the study of patients with myocardial and coronary disabilities. Experience over the past 15 years has shown that the electrodynamic pattern may change remarkably after effort in certain individuals who have a marginal cardiac reserve; insofar as muscular work produces a relative anoxic phase in myocardial metabolism, associated electrocardiographic changes may occur. The interpretation of these changes have, however, been a matter of some debate. Where the exercise test has been standardized, clinical correlation of the results have generally been satisfactory in the hands of experienced examiners. A number of these tests are in use; the Wolffe ergometer; Parsonnet's stationary bicycle; Sussman's weight-lifting device; my own stairway treadmill, which was used in the medical department of the Navy during World War II— all permit a definitive amount of work to be performed. The stair-climbing test,


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