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April 22, 1939


JAMA. 1939;112(16):1620. doi:10.1001/jama.1939.02800160084027

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To the Editor:—  In an article entitled "Relation of Physical Exertion and Emotion to Precipitation of Coronary Thrombi" in The Journal, March 11, Dr. J. C. Paterson categorically stated that coronary thrombi are precipitated by exertion and emotion. This is contrary to our observations previously published in The Journal and elsewhere.In the summary the author states that "activities of a patient immediately preceding the onset of an attack of coronary thrombosis have no relation to the etiology of the precipitation of a thrombus but are purely coincidental." Yet the very next sentence is "The pathologic appearances in a series of fatal cases of coronary thrombosis suggest strongly that exercise and emotional stress are intimately concerned in the mechanism of coronary artery thrombosis." These statements are contradictory.If the author means unusual activities a few hours to a few days prior to the closure rather than the activities immediately preceding

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