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October 3, 1942


Author Affiliations

Bethesda, Md. Commander, M. C., U. S. N. R.

JAMA. 1942;120(5):392. doi:10.1001/jama.1942.02830400066026

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To the Editor:—  In the August 22 issue of The Journal, on page 1431, is an editorial comment entitled "Total Collapse Associated with Physical Exertion." I must take issue with the authors quoted who conclude that severe physical exertion or trauma can produce coronary occlusion.Reviewing the recent report of Jokl and Suszman (Mechanisms Involved in Acute Fatal Nontraumatic Collapse Associated with Physical Exertion, Am. Heart J.22:761 [June] 1942) you write that these authors, analyzing 66 cases of sudden death in which clinical data and complete necropsy reports were available, came to the not unexpected conclusion that collapse following exertion is almost invariably due to circulatory disease of long standing. You say that the authors found that acute coronary occlusion was the second in order of frequency of the "circulatory disease of long duration" found at necropsy. Actually, however, in this particular article no "clinical data and complete

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