RT Journal
A1 Kleinman LA
T1 POstoperative sign of silent myocardial infarction
JF Journal of the American Medical Association
JO Journal of the American Medical Association
YR 1959
FD October 3
VO 171
IS 5
SP 591
OP 592
DO 10.1001/jama.1959.03010230089022
UL http://dx.doi.org/10.1001/jama.1959.03010230089022
AB To the Editor:— 
    I have read the article in The Journal, July 4, 1959, page 1147, by Dr. Nathan Frank, describing the cold foot as a postoperative sign of silent myocardial infarction. This would be an interesting observation if adequately substantiated. However, it is wise to exhibit caution on interpretations of such a positive sign without adequate pathological explanation of its pathogenesis. It would be tragic, indeed, if patients were not given the benefit of embolectomy or other definitive treatment directed at the extremities on the assumption that this could be due in some unexplained way to silent myocardial infarction.It is difficult to adequately interpret electrocardiograms from small reproductions such as those that accompany this article. However, after close scrutiny, I feel that in case 1 an anteroseptal infarction is certainly apparent, but I do not believe that its age can be determined from this tracing. In case 2