Myocardial Infarction—A Ten-year Experience in a Midwestern General Hospital

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Abstract
This analysis relates a 10-year experience in diagnosis, treatment, and prognosis of 351 patients with acute myocardial infarction. There were 6.8 infarctions for every 1000 admissions. The incidence per 1000 general admissions per year increased significantly during the decade. Cardiac infarction occurred in patients as young as 24 years of age, and as old as 92, the average for men being 58 years, and for women, 65. The over-all ratio of men to women was 2.5:1, but this ratio decreased in the older age groups until women eventually outnumbered men. No seasonal influence was noted. In 11.3% of our cases, the ecg was not diagnostic. However, no patient with acute myocardial infarction had a normal ecg. The expected complications were observed, yet their true incidence was open to question, since they depended on the physician''s inclination to record accurate observations. Shock occurred in 11.3% of the cases. Over-all mortality during the acute phase was 18.2%; at the end of the period, 42.4% of the patients were known to be dead. One year after initial myocardial infarction (not based on survival of the 1st or 2d month) 31% were dead, and 36% of those living were asymptomatic. Four years after initial myocardial infarction (not based on survival of the 1st or 2d month) 48.5% were dead and 20.5% of the survivors were asymptomatic. Of the 149 patients known to be dead at the end of 10-year period, the ultimate cause of death in a large majority was myocardial infarction.