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Clinical Outcomes After Inferior Myocardial Infarction

JAMES NASMITH, M.D.; DEREK MARPOLE, M.D.; DERIC RAHAL, M.D.; JEAN HOMAN, R.N.; SUSAN STEWART, R.N.; and ALLAN SNIDERMAN, M.D.
[+] Article and Author Information

Grant support: the Cardiology Follow-up Centre was supported in part by funds from the Joseph Edwards Foundation. Dr. Sniderman is the Edwards Professor of Cardiology, McGill University.

▸Requests for reprints should be addressed to Allan Sniderman, M.D.; Cardiovascular Research Unit, Room M4.14, Royal Victoria Hospital; 687 Pine Avenue West; Montreal, Quebec, Canada, H3A 1A1.


Montreal, Quebec, Canada


© 1982 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1982;96(1):22-26. doi:10.7326/0003-4819-96-1-22
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We studied the clinical outcomes of 46 patients followed prospectively for the initial 6 months after inferior infarction. Twenty-one patients (Group A) had no anterior ST depression (V2 to V4) present during the acute phase of the inferior infarction, whereas 25 patients (Group B) had such findings transiently. Although the clinical course during hospitalization was similar in the two groups, that after discharge differed. Only one of 21 patients in Group A had exertional angina and none had rest angina during follow-up; no infarcts or deaths occurred. In contrast, 15 patients in Group B had exertional angina; 12 also had rest pain (p < 0.001, exact probability test). Two patients had reinfarction, one of whom died, and one sudden death also occurred. Of 15 patients in Group B who had cardiac catheterization, only eight had significant lesions in the anterior vessels, whereas seven did not; six of the seven patients became asymptomatic during follow-up without surgical therapy. Thus, electrocardiograms taken during the early phases of inferior myocardial infarction may be a valuable tool to recognize patients likely to have further ischemic symptoms during the early follow-up period.

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