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Correspondence
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Volume 335:594-596 August 22, 1996 Number 8
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Management of Acute Mesenteric Ischemia

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 by Sirmon, M.
To the Editor: The Clinical Problem-Solving article entitled "The Invisible Patient" (April 4 issue)1 describes a patient who died of bowel ischemia that manifested clinically several hours after coronary angiography. The discussant attributed the ischemic event to the dislodgment of an atheromatous plaque by arterial catheterization. Two days earlier, however, the patient had undergone cardioversion for atrial fibrillation of unknown duration. The discussant rejected the possibility of a left atrial thrombus as a potential embolic source because two days had elapsed since cardioversion.

Thromboembolism occurring hours to days after the restoration of sinus rhythm is a well-known complication of cardioversion . . . [Full Text of this Article]

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