Subendocardial myocardial infarction: a follow-up study of 55 cases

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Abstract
Fifty-five consecutive patients without antecedent myocardial necrosis and presenting with an acute episode of subendocardial myocardial infarction were studied and followed–up for an average of 19.1±8 months (range 6–36). Both enzymatic and scintigraphic studies confirmed the small size of the infarcts. The short–term prog–nosis of these patients was good and showed alow in-hospital mortality (2%) and complication rate (15%). In contrast with the initial outcome, the subsequent follow-up was characterized by a high incidence of severe complications (cumulative incidence at two years: death 13% recurrent myocardial infarction 32%; episodes of unstable angina 32%). This is most probably accounted for by the extent and severity of coronary atherosclerosis disclosed in some of these subjects. Indeed, 11 out of the 18 patients who under–went coronary arteriography were found to have triple vessel disease or left main coronary stenosis. Patients showing extensive anterior ST–T changes with lateral or inferior involvement had a particularly poor prognosis (10 out of 11 suffered late complications). These data confirm the need for careful assessment of patients with subendocardial myocardial infarction.

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