1986 Volume 23 Issue 6 Pages 600-604
The clinical and pathological features of acute myocardial infarction were analyzed with respect to subjective symptoms in 153 autopsy proven cases (70 men 83 women, mean age 78.5 years). Although the chest pain was the most frequent symptoms of the acute myocardial infarction, the incidence was only 36 percent. Other major symptoms were dyspnea; 19 percent, shock; 17 percent, and disturbance of consciousness; 13 percent. The mean age of painless myocardial infarction group was 80.8 years, and significantly older than that of patients with chest pain, 76.1 years (p<0.01). The incidence of chest pain decreased with advancing age; the incidence of chest pain was 62.5, 38.7, and 29.0 percent in sixties, seventies, eighties, respectively. The incidences of diseases coincident with acute myocardial infarction in groups with and without chest pain were as follows; cerebrovascular disease (21.4 vs 46.3 percent, p<0.01), disseminated intravascular coagulation (12.5 vs 24.7 percent, ns), malignancy (14.2 vs 26.8 percent, ns), and diabetes mellites (30.4 vs 28.9 percent, ns), respectively. On autopsy, the posterior infarction was more frequent in painless myocardial infarction group than in patients with chest pain (36.3 vs 19.6 percent, p<0.05). Left coronary arteries were more significantly involved in the chest pain group (55.4 vs 34.0 percent, p<0.01), and the recurrence of myocardial infarction was more frequent (62.5 vs 49.5 percent, p<0.05) compaired with painless group. The size of myocardial infarction was not significatly different.