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	Since this article does not have an abstract, we have provided the first 125 words of the full text and any section headings.

To the Editor: The Grand Rounds by Dr Ziegelstein on near-syncope after exercise¹ sent me back nearly 40 years when, as a senior medical resident at Henry Ford Hospital, I encountered a similar unforgettable patient. I considered myself a good history taker, but no matter how I probed and cajoled, all I could ever get this 66-year-old man to say was "I get that unnecessary feeling." He just wouldn’t elaborate. I had an interest in carotid sinus hypersensitivity and so I performed carotid sinus massage. Just as the electrocardiogram began to show the classic ventricular pause demonstrated in the article, the patient exclaimed, "That’s it!" "What?" I asked. "I just got that unnecessary feeling," he said. I did too, until his normal rhythm resumed.

Leo J. Bingley, Jr, MD
bingley@torchlake.com
Michigan State University College of Human Medicine
Eastport

1. Ziegelstein RC. Near-syncope after exercise. JAMA. 2004;292:1221-1226. FREE FULL TEXT

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292:2836.

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