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February 11, 1974

Exercise and Cardiac Death

Author Affiliations

Mount Zion Hospital San Francisco

JAMA. 1974;227(6):661. doi:10.1001/jama.1974.03230190053029

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To the Editor.—  As the senior author of "Instantaneous and Sudden Deaths" (225:1319, 1973), I should reply to the critical comments of both Dr. Bruce and Dr. Dodge (226:1229, 1973) concerning this article.The main thrust of our article did not concern itself with the possible injurious effects of violent exercise, but rather with the clinical and pathological differentiation of instantaneous from sudden coronary death.Both Bruce and Dodge state that we did not define the kinds of exertion preceding the deaths of our subjects. Our article reported the fatality-inducing exertions—jogging, running, and handball.Both drew conclusions from our paper that our data did not warrant. Dr. Bruce assumed that the dying subjects we studied had collapsed, as did his initial seven patients, in the immediate vicinity of a defibrillator. None of our subjects had done so. Dr. Dodge in turn stated that we implied that exercise was bad for