JOSEPH STOKES III, M.D.; THOMAS R. DAWBER, M.D., F.A.C.P.
Pain has been recognized as the cardinal manifestation of acute myocardial infarction ever since Herrick's original description of the clinical syndrome in 1912,1 and the belief is generally held that the precordial discomfort is due to severe, prolonged myocardial ischemia. However, with increased experience and better diagnostic methods, physicians soon recognized that myocardial infarction could occur without pain, and subsequently the frequency of painless coronary attacks has been the subject of repeated study and debate.2-13 Davis5 analyzed the clinical manifestations of pathologically proved myocardial infarctions and was able to find the characteristic pain recorded in only 36 (47%). In 29
STOKES J, DAWBER TR. THE "SILENT CORONARY": THE FREQUENCY AND CLINICAL CHARACTERISTICS OF UNRECOGNIZED MYOCARDIAL INFARCTION IN THE FRAMINGHAM STUDY1. Ann Intern Med. ;50:1359–1369. doi: 10.7326/0003-4819-50-6-1359
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Published: Ann Intern Med. 1959;50(6):1359-1369.
Acute Coronary Syndromes, Cardiology, Coronary Heart Disease.
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