CLINICO-PATHOLOGICAL CORRELATIONS IN THE DIAGNOSIS OF ACUTE MYOCARDIAL INFARCTION IN THE ELDERLY

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Abstract
A series of 200 consecutive patients with autopsy-proven acute myocardial infarction (AMI) was retrospectively studied in order to assess the degree of clinico-pathological agreement and to detect the reasons for disagreement. A correct clinical diagnosis of AMI was made in 86 cases (Group A=43%) and was missed in 114 cases (Group B=57%). Atypical presentation and concealed history were more common in group B. The AMI qualified to be the main disease in 83 patients of group A and in 81 of group B and was considered a contributory cause of death in three of group A and in 33 of group B ( P P P P P <0.001). Ageing, the atypical presentation and the coexistence of several diseases seem to account for most of the unrecognized AMI.