THE CHANCES FOR RECOVERY

PRESIDENT Eisenhower's attack, and his good recovery to date, have given national urgency to questions that have always troubled heart patients and their families: How good a recovery can a patient make after a coronary thrombosis, and what are his chances of resuming an ordinary, active life? While each case is different, the answer that most heart specialists are now trying to put across to the country is: the chances are far better than generally realized.

The medical profession itself did not fully understand this even 20 years ago. The general feeling used to be: the less activity the better. Recently, searching tests have been conducted to find out just how much or how little an injured but healed heart can stand. Manhattan's Bellevue Hospital and Dr. Arthur M. Master have pioneered in finding out how much work heart sufferers can safely do. Many victims have been found to suffer from nothing but a wrong diagnosis. Others, after recovering from an attack, have been handicapped more by their own anxiety (and occasionally their doctor's) than anything else. About three-fourths can soon go back to work, most at their old jobs, though some must settle for lighter tasks.

Promoted by the American Heart Association, this principle is now being applied nationally through 48 state-federal programs. Classification units grade the patient's capacity for work and such items as his emotional status and especially anxiety about his heart. They also grade the demands of the jobs available, try to fit workers to jobs. Labor unions and industry groups are backing the effort. Some employers shy away because of compensation problems, but the problems have no medical basis: heart cases are more safety-conscious than other workers, likely to be steadier and more reliable. Properly job-graded, they produce as much as their healthier fellows--sometimes more.

Doctors are able to give patients improved care now that they take more and better electrocardiograms (using twelve leads instead of the former three), regulate the diet after an attack, and prescribe permissible exercise. This may range from walking two blocks a day to playing three sets of tennis. The benefits to heart sufferers come not so much from new discoveries or drugs as from spreading a realization, first among doctors and then among laymen, of what the facts are:

P:At least 80% of coronary victims survive their first attack; among private patients (likely to have better diagnosis and more individual care than ward patients) the rate goes up to 95%.

P:Among large numbers of patients studied up to 30 years after an attack, 40% have made full recoveries in activity (though some showed electrocardiographic or other signs of hidden damage). Another 40% have made good recoveries with only mild symptoms.

P:The outlook for those patients who go back to their work is at least as good as it is for those who retire.

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