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February 1959

Unrecognized Myocardial Infarction: A Clinicopathologic Study

Author Affiliations

Rochester, Minn.

Mayo Clinic and Mayo Foundation. Fellow in Medicine, Mayo Foundation (Dr. Johnson); Section of Medicine (Drs. Achor and Burchell); Section of Pathologic Anatomy (Dr. Edwards). The Mayo Foundation, Rochester, Minn., is a part of the Graduate School of the University of Minnesota.

AMA Arch Intern Med. 1959;103(2):253-261. doi:10.1001/archinte.1959.00270020081009

Although myocardial infarction has become increasingly well recognized, there continue to appear at necropsy myocardial infarcts, especially healed ones, which had been unrecognized clinically. It is also apparent that these unrecognized infarcts represent a considerable proportion of the myocardial infarcts at necropsy.1 It was therefore felt worth while to study the case histories and the necropsy data on patients with myocardial infarction in order to determine the incidence of clinical nonrecognition and attempt to clarify some of the factors that obscured the diagnosis.

Methods  Cases for study were selected from the necropsies performed at the Mayo Clinic during the years 1953 and 1954. To be included in this study the case had to meet three prerequisites: (1) The medical record had to be apparently adequate with respect to the past history, physical examination, and details of the symptoms at the onset of the final illness; (2) the heart had

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