Long range observations in fifty-three young patients with myocardial infarction

Abstract

Fifty-three young patients aged 21 to 40, 2 women and 51 men, were studied from 1 to 16 years after their first myocardial infarction. All patients were white, despite a Negro population of 15 per cent in greater New Haven. Twelve patients had died by the end of the study. One died in the hospital on the third day after the first attack and one died on the third day after the third attack. Recurrent infarctions occurred in 18 patients, and 10 of these died suddenly. The initial prognosis for survival for the young patient after he remained alive for several hours at the hospital was excellent. The majority of patients resumed work without appreciable loss of time, and only 2 requested workmen's insurance compensation. The patients were primarily skilled and unskilled workers with only a high school education or less. Most were tense, ambitious people who worked long hours, were heavy smokers, had elevated serum cholesterol and uric acid levels and had strongly positive family histories of vascular disease. Nine patients had duodenal ulcers and eight had arcus senilis. Angina or cardiomegaly, or both, after infarction indicated a poor prognosis. Body weight had no correlation to recurrent infarction or fatality. Return of the electrocardiogram to normal was a good prognostic sign.