Comparison of the effects on the circulation of ascending an incline and mounting stairs: Observations on normal subjects and patients with coronary heart disease

(1) Observations have been made of the effect of various forms of effort 011 cardiac work. The exercises employed were ascending a ramp, mounting a flight of stairs, descending the stairs and walking on level ground. The subjects were 5 normal persons and 5 patients with coronary heart disease. (2) The low frequency, critically-damped ballistocardiograph was used to measure cardiac output. Cardiac work, stroke volume, pulse pressure and heart rate were also recorded. (3) On repetition of a given exercise, the effects on the circulation showed considerable variation within the individual as well as between individuals composing a group, in both normals and cardiacs. (4) The ascent of a short incline, like mounting an ordinary staircase, does not impose a markedly increased burden of work on the heart. The response of the patient with compensated coronary disease is not significantly greater, following this exercise, than after descent and is only slightly greater than after walking for an equivalent distance on the level. There is likewise no significant difference between the normal and cardiac groups. (5) Patients with coronary heart diesase may safely be permitted to ascend inclines of moderate steepness and length, provided the ascent can be made without inducing undue dyspnea or anginal pain.