April 4, 1977


Author Affiliations

Northwestern University Medical School Chicago

JAMA. 1977;237(14):1434. doi:10.1001/jama.1977.03270410034008

To the Editor.—  I read with interest the article by Cosby et al on late complications of myocardial infarction (236:1717, 1976). The authors have very succinctly described the problems faced both by the patient and his physician following an acute myocardial infarction. As the authors correctly point out, the state of left ventricular function is one of the most important determinants in the long-term prognosis of these patients.Whereas all the techniques discussed by them (invasive and noninvasive) are invaluable in the assessment of left ventricular function, I am a bit surprised that no mention was made of apexcardiography. This is a simple, noninvasive technique, and with practice and patience, a satisfactory apexcardiogram can be obtained in more than 90% of the cases. The technique can be repeated frequently with little discomfort to the patient, and graphic records may be kept for future comparison. With the well-established dynamic measurements of