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In Reply: Dr Wrenn is correct. Perhaps not surprisingly, we support his diagnosis of an innocent mistake. In the redrafting of our manuscript, the superscripts for references 52 and 53 were interchanged. As a result, the 1976 article by Dr Schwartz describing the common use of the GI cocktail to distinguish cardiac from esophageal chest pain was misattributed to Wrenn (publication precocity) and Wrenn's subsequent article challenging this practice to Dr Schwartz. We apologize for this typographical error and for necessitating the cocktail nostrum Wrenn describes, GI or otherwise.

Although our literature search discovered Dr Goodacre's 2002 article, it failed to identify the one he published in 2003. It is encouraging that the findings he describes substantiate those we discovered. His conclusion that chest pain radiating to the left arm, the right arm, or accompanied by vomiting is significantly associated with ACS supports our data in Table 2 and our . . . [Full Text of this Article]

John T. Nagurney, MD, MPH
jnagurney@partners.org

Clifford J. Swap, MD, MS
Massachusetts General Hospital
Boston

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