Alexios IV segera dicekik oleh Alexios Doukas Mourtzouphlos, kekasih Efrosini putri Eudokia, yang kemudian memproklamirkan dirinya sebagai kaisar Alexios V. Pada bulan April 1204 Efrosini meninggalkan kota bersama putrinya dan Alexios V, dan mereka berjalan ke Mosynopolis, di mana suami Efrosini, Alexios III mengungsi.
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