the group of patients who had made a complete func¬ tional recovery and were asymptomatic. Thirty-two of these symptomless patients (15.3%) had greatly en¬ larged hearts and marked electrocardiographic changes. In almost half of these patients, a definite diagnosis of ventricular aneurysm was made. Yet, only five have died, and a significant percentage have lived for more than 10 years. The longest survival period in this entire series (29 years) fell into this group. The most important prog¬ nostic indicator, in patients who have recovered from coronary occlusion, is how the patient feels. Neverthe¬ less, if the physical examination, electrocardiogram, heart size, and pulsations become normal, the patient has probably made an excellent recovery, and his outlook is good. Of 39 patients with normal objective findings, 32 were asymptomatic (group 1A) and 7 experienced oc¬ casional mild angina (group 2A). Only 2 of the 39 have died. It is hoped that the findings presented in this and in previous reports will gradually dissipate the wide¬ spread pessimism among physicians and laymen about coronary occlusion. More and more, medical and heart associations are disseminating the facts about the disease and enlisting the aid of industry in placing cardiac pa¬ tients at work. More remains to be accomplished. Physi¬ cians should join in encouraging these patients to be pro¬ ductive and independent. The problem, however, can be solved only by the cooperation of the entire community.
SUMMARYIn a follow-up study of 500 patients who had survived a coronary occlusion for from 1 to 29 years, it was found that 2 out of every 5 patients had made a complete functional recovery. A similar number made a satisfac-tory recovery, in that they experienced only mild anginal pain or dyspnea on exertion. Three-quarters of these patients were, for the most part, working. Over half of the patients had already lived more than five years after the attack, and one out of every five survived for more than 10 years. Among the patients who made a complete or a satisfactory recovery, only one out of every five died.Death usually occurred as a result of another coronary occlusion or of congestive failure. The most reliable gauge of recovery after coronary occlusion is the absence of cardiac symptoms, regardless of the objective findings. Many patients who have made a complete or good func¬ tional recovery have large hearts, marked electrocar¬ diographic changes, and, not infrequently, ventricular aneurysm. Nevertheless, when the physical examination, electrocardiogram, heart size, and cardiac pulsation are normal, the patient has almost always made an excellent recovery and his outlook is good. Another coronary oc¬ clusion may develop many years later in patients who have recovered completely, and they may again recover fully. The site of the infarction does not affect the prog¬ nosis after coronary occlusion. The outlook is somewhat better in younger patients. The patient and the physician should be optimistic about the prognosis in coronary occlusio...