I am unable to find in the literature a description of the clinical picture of myocardial infarction in the Negro. The diagnosis is rarely made clinically. Hence it is my purpose to describe the clinical characteristics of myocardial infarction in the Negro, to indicate that the disease is as common in the Negro as it is in white persons of comparable age groups and to emphasize that the diagnosis is obscured in the Negro only because dyspnea is the chief complaint and pain is absent. Because I can find no evidence to support the belief that the Negro does not feel pain as well as the white person, I offer as an explanation for the absence of angina in the Negro the fact that he develops hypertension much earlier than the white person and probably thereby dilates his coronary collateral circulation. Reports from Grady Hospital in Atlanta, Ga., indicate that