β-Blocker Therapy for Heart Failure

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Abstract
The young intern, Dr O'Connor, is beginning his rotation in the cardiac care unit in 1983. His faculty attending, Dr Califf, notices that Dr O'Connor has initiated β-blockade in a patient with heart failure. The discussion that ensues does not reflect positively on Dr O'Connor's future career. In 2000, both physicians realize that their understanding of blockade of the β-receptor as a simple matter of reducing myocardial contractility was shortsighted and fundamentally incorrect. Dr O'Connor had initiated the right therapy but for the wrong reason.