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Robert S. Green, M.D.; Erna L. Borousch, M.D.
JAMA. 1960;172(8):783-789. doi:10.1001/jama.1960.03020080013005.
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In the experience of the authors it has never been necessary to resort to surgical procedures to relieve a patient of anginal attacks. Considerations here outlined have led to a program for building up collateral circulation in the coronary vessels in anticipation of eventual coronary occlusions or excessive demands on the myocardium. It is insisted that the patient be underweight. Factors inducing anginal attacks must be eliminated, and nitroglycerine must not be misused simply to escape the penalties of overburdening the heart. During subsequent rehabilitation the patient should be concerned more about returning to his job than to his advocations. In 13 years of experience with the type of patients here specified, relief from the symptoms of angina, even of the so-called intractable type, has been achieved in all patients who adhered to the plan, and most of them have returned to their former occupation.


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