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Psychologic Adaptation to Pacemaker and Open Heart Surgery

Barney M. Dlin, MD; H. Keith Fischer, MD; Benjamin Huddell, MD
Arch Gen Psychiatry. 1968;19(5):599-610. doi:10.1001/archpsyc.1968.01740110087010.
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OUR STUDY, based on experience with and knowledge of the psychiatric complications common before and after heart surgery, holds that each patient undergoing heart surgery should be seen by a psychiatrist for evaluation and treatment.

Psychiatric consultation in conjunction with heart surgery is commonly observed now, and we predict that it will be increasingly, but such consultation should be routinely prescribed in each case. We are limited at present by the relatively few psychiatrists trained to work in this field although we have noted great steps forward both medically and surgically.

It is estimated that in 1968 approximately 10,000 patients will require a temporary or permanent pacemaker, and that 30,000 to 50,000 patients will undergo open or closed heart surgery. Even in the face of these numbers, there has been little written on the detailed psychodynamics that the patient experiences and works through during this emotionally charged, life threatening


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