How common is clinically unsuspected healed myocardial infarction among patients in a general hospital? In order to answer this question, we reviewed a series of 5000 consecutive autopsies from 1945 to 1955, inclusive, at this 500-bed general hospital. This is the county hospital of Wayne County, in which the city of Detroit is located. In addition to the general hospital division, the institution has a psychiatric division with about 3500 mental patients and an infirmary with about 2500 indigent inmates (about 2030 men and 470 women).
After selecting the autopsy protocols of cases with old myocardial infarcts, the corresponding clinical charts were reviewed, with particular reference to evidence of cardiac or vascular disease. All cases were excluded in which the clinical history or electrocardiographic, radiologic, or physical findings led to a diagnosis or to suspicion of myocardial infarction, whether old, recent, or fresh. A systolic blood pressure of 160 mm.
S. E. GOULD, L. P. CAWLEY. Unsuspected Healed Myocardial Infarction in Patients Dying in a General Hospital. AMA Arch Intern Med. 1958;101(3):524–527. doi:10.1001/archinte.1958.00260150012002