"Armchair" Treatment of Acute Coronary Thrombosis

Rest for a diseased organ, be it a fractured limb or a tuberculous lung, is a therapeutic principle validated by clinical experience. It is believed that activity, with its complex biochemical and physical demands, diverts from the reparative process the available energy essential for optimal healing. When the heart is diseased, the only feasible application of the principle of rest is the attempted diminution of the cardiac load. Rest in bed has been traditionally regarded as tantamount to optimal rest for the heart. This is the practice in congestive heart failure and finds its most rigid application in acute coronary thrombosis, when the patient is placed flat in bed for three to six weeks.1 It has been our view that recumbency in bed affords less rest to the heart than the sedentary position in a chair with the feet down.2The recumbent position permits maximal venous return from