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July 29, 1939


JAMA. 1939;113(5):440. doi:10.1001/jama.1939.02800300070023

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To the Editor:—  An article entitled "Angina Pectoris and Cardiac Infarction from Trauma or Unusual Effort" by Dr. E. P. Boas, published in The Journal May 13, is devoted in large part to the rebuttal of my observation that physical effort is not a factor in precipitating coronary artery occlusion. I have already presented arguments and shall not repeat them; evidence has now been extended to 1,500 cases and will be published elsewhere. My purpose in writing is to correct several beliefs erroneously attributed to me by the author and to point out that some of his conclusions are unwarranted.The author gives the impression that trauma was excluded as a cause of cardiac damage and symptoms. This is not true; it is universally admitted that trauma can produce contusion of the heart. It is my belief, however, that trauma does not initiate classic coronary occlusion with secondary cardiac infarction

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