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August 1963

Angina Pectoris Preceding Initial Myocardial Infarction: A Clinicopathologic Study

Author Affiliations


Fellow in Medicine, Mayo Foundation (Dr. Francis); Section of Medicine (Dr. Achor); Section of Pathologic Anatomy (Dr. Brown).

Mayo Clinic and Mayo Foundation.

Arch Intern Med. 1963;112(2):226-233. doi:10.1001/archinte.1963.03860020124017

Angina pectoris, in its classic form, has been recognized clinically since 1768, when Heberden 1 first described it so clearly that little has been added since that time. Angina pectoris is a well-accepted indication of myocardial ischemia which most often is due to coronary artery disease2; however, its specific relationship to myocardial infarction, both clinically and pathologically, deserves further attention. Information concerning the significance of angina pectoris preceding initial myocardial infarction, as opposed to infarction without antecedent angina, would seem to be of practical value, but there is surprisingly little in the literature relative to this comparison. There are, however, studies dealing with survival rates of patients with angina pectoris.3-5 Hence, this study was undertaken to evaluate and compare the clinical features and pathologic anatomy of the hearts of two groups of patients: (1) those with angina pectoris preceding their initial myocardial infarction, and (2) those who sustained