In a study of the clinical and pathologic findings in a series of 350 cases, we have observed multiple fresh coronary occlusions in a group of 11 cases. In 8 of these, multiple fresh thrombi had occluded the arteries; in the remaining 3 cases multiple occlusions were due to hemorrhages within the atheromatous plaque and to ruptured atheromatous abscesses. The hearts in these 11 cases were studied by the method of injection and dissection of the coronary arteries previously described.1 The striking observation was made that all these instances of multiple fresh occlusions occurred in the presence of shock. A search of the voluminous literature on coronary thrombosis and myocardial infarction, as well as reference to the standard cardiologic texts, has failed to reveal any publications dealing with this correlation between shock and multiple coronary occlusion, although the existence of multiple fresh thrombi has been noted by several observers.
BLUMGART HL, SCHLESINGER MJ, ZOLL PM. MULTIPLE FRESH CORONARY OCCLUSIONS IN PATIENTS WITH ANTECEDENT SHOCK. Arch Intern Med (Chic). 1941;68(2):181-198. doi:10.1001/archinte.1941.00200080003001