Totally Asymptomatic Myocardial Infarction: An Estimate of Its Incidence in the Living Population

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Abstract
Introduction Many clinicopathologic studies have been performed which report the presence at autopsy of myocardial infarctions unsuspected during life.2-5 From these studies the concept has evolved of painless, silent, occult, or asymptomatic myocardial infarction. In contrast to the wealth of necropsy material on painless myocardial infarction, there is a paucity of clinical reports describing totally asymptomatic myocardial infarction diagnosed during life.6 This report presents three such cases, and offers an estimate of the incidence rate of totally asymptomatic myocardial infarction in our urban, white, middle-aged male population. Methods A comprehensive study was made of the case records of the medical department of a Chicago utility corporation for the four-year period 1954-1957.7 During this period 756 male employees (737 white, 19 nonwhite) in the age group 50-59 as of Jan. 1, 1954, underwent a voluntary yearly medical review consisting of a complete history and physical examination, 14×17 roentgenogram

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