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To the Editor:—
The article "Cold Foot—Postoperative Sign of Silent Myocardial Infarction," by Dr. Nathan Frank, in The Journal, July 4, 1959, page 1147, deserves comment. Dr. Frank states: "The purpose of this paper is to describe a syndrome that has not been previously reported." The occurrence of a cold foot postoperatively is not a syndrome, nor is it a sign of anything except possible interference with the circulation to that particular extremity. Dr. Frank mentions the numerous sources of emboli which may cause vascular occlusion in a distal vessel. To these should be added thrombosis in situ and selective vasoconstriction without "organic" cause.No electrocardiograms were taken preoperatively and no mention is made of serial changes in tracings subsequent to those illustrated. This would be particularly important in case 3, since the tracing illustrated is quite typical of those seen in pulmonary infarction, which the patient soon was proved
Durham JR. POSTOPERATIVE SIGN OF SILENT MYOCARDIAL INFARCTION. JAMA. 1959;171(5):591. doi:10.1001/jama.1959.03010230089021
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