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Novmber 21, 1959


Author Affiliations

135 Eastern Pkwy. Brooklyn 38, N. Y.

JAMA. 1959;171(12):1730. doi:10.1001/jama.1959.03010300104029

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To the Editor:—  The author of "Successful Treatment by a Chest Blow of Cardiac Arrest During Myocardial Infarction" in The Journal, July 11, protein have been extensively investigated. page 1307, is to be complimented on his prompt recognition and treatment of cardiac arrest. However, the history of sudden severe pain deep in the midsternal area, with radiation to both arms, normal respiratory rate and temperature, increasing pain despite opiates, and maintenance of blood pressure of 150/80 mm. Hg, suggests a dissecting aneurysm. This view is strengthened by the author's report of the five normal and static serial electrocardiograms made over a seven-month period and four normal transaminase test results. In this case the dissection must have healed spontaneously, as it frequently does, but there is a tendency to recurrence because of the presence and progression of the underlying aortic disease. Under these circumstances, it would be inadvisable to institute a

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