Myocardial infarction: a clinical study of the aetiology and prognosis, with special reference to the influence of anti-coagulant therapy on prognosis

Abstract

1. A historical review of myocardial infarction in all its clinical aspects is presented.

2. The increasing importance of myocardial infarction as a cause of death has been investigated by a study of the annual reports of the Registrar- General for Scotland between 1937 and 1947.

3. The aetiology of coronary thrombosis with myoca dial infarction is briefly reviewed and two clinical factors of possible importance are reported.

4. The clinical details of a series of 100 cases o myocardial infarction treated conservatively are de- tailed, and the features of importance in estimation of immediate prognosis discussed. The survivors have been followed up and the clinical course pursue has been analysed to determine the factors governing ultimate prógnosis.

5. A series of 70 cases treated with anti - coagulan has been similarly analysed and compared with the conservatively treated series, to determine the valu of this measure in (a) immediate prognosis, and (b) ultimate prognosis.

6. Clotting changes which occur after myocardial infarction are presented and tentative suggestions made as to the response of the body to the presence of a mass of infarcted tissue.

7. pecific anti -shock therapy is summarised and experience with 3 cases cited.

8. Embolic coronary artery occlusion is briefly mentioned and six cases are listed. The incidence of coronary artery embolism in subacute bacterial endocarditis is presented.

9. serial electro- cardiograms obtained in 65 cases using standard limb leads, augmented unipolar limb leads, and unipolar praecordial leads,have been anal- ysed, and the features of diagnostic importance stressed.

10. The conclusions are presented.

11. Finally clinical details of 35 cases are report- ed.