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To the Editor:—
In an article in The Journal, July 14, entitled "The Relation of Effort to Attacks of Acute Myocardial Infarction," Blumgart has challenged the work of my associates and myself. He believes that in a "small proportion" of cases strenuous exercise may induce coronary occlusion. We believe that in no instance is there any relation.First one must distinguish clearly between myocardial infarction due to coronary occlusion and that occurring without this complete obstruction. Correct terminology is absolutely essential in discussions of this subject. I take it that Blumgart refers to coronary occlusion, since coronary thrombosis was found in the 4 patients that came to autopsy. In the other seven I am not so sure. I am well aware that effort may precipitate myocardial infarction without coronary occlusion, induce heart failure and, in fact, cause sudden death. Coronary occlusion is something else again. It is the end result
Master AM. THE RELATION OF EFFORT TO ACUTE ATTACKS OF MYOCARDIAL INFARCTION. JAMA. 1945;129(1):90–91. doi:10.1001/jama.1945.02860350092024
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