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February 8, 1919


JAMA. 1919;72(6):387-390. doi:10.1001/jama.1919.02610060001001

In a paper1 on certain clinical features of sudden obstruction of the coronary arteries, read six years ago before the Association of American Physicians, I called attention to the fact that while such obstruction as by a thrombus was very often suddenly fatal, it was not necessarily so; for the coronary arteries were not in the strictest sense terminal arteries; there were often anastomoses capable of reestablishing circulation in the infarcted area to such an extent as to enable the heart to functionate for a time at least. This had been shown by anatomic study of the coronaries, by necropsy observations by the pathologists, by experimental ligation of these vessels, and by clinical experience controlled by postmortem examinations.

A tentative grouping of the cases of coronary thrombosis based on clinical symptoms was made:

  1. Cases of instantaneous death, a group graphically described by Krehl, in which there is no death