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Calvin F. Kay, M.D.
JAMA. 1957;164(6):659-667. doi:10.1001/jama.1957.62980060001009.
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The symptoms and physical signs of congestive failure are well known in clinical practice, and the common forms of therapy are widely and effectively used. In the past several years, a great deal has been learned about the hemodynamic and chemical disturbances associated with congestive failure. Generally this has been made possible by the wide application of advanced techniques for the measurement of cardiovascular dynamics (cardiac catheterization, indicator-dilution methods), for the investigation of hormonal chemistry and physiology, especially that of the adrenal gland, and for the study of body water and electrolytes. The many observations have been so variously interpreted that no uniform agreement exists upon even the general outline of the pathogenesis of congestive failure, and, for lack of information, many important details are either controversial or obscure.

Pathogenesis  Although congestive failure may be the ultimate result of a single anatomic lesion such as syphilitic aortic insufficiency and may


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