The clinical course of 138 patients who died after an acute myocardial infarction have been reviewed, with the aim toward elucidating those features which might influence the possibility of resuscitation. The majority of the deaths occurred unexpectedly, presumably as the result of an acute arrhythmia. Failure of the heart to function adequately as a pump was noted in 44 per cent-three fifths of these patients died from congestive heart failure, and two fifths from circulatory collapse. Seventy-four per cent of the deaths occurred within a 5-day period of hospitalization. The sex, age, and presence of previous cardiac disease showed no association with the manner of dying. Patients over 70 years of age did not die more frequently in shock, but did die from congestive heart failure slightly more often than expected. Even when the past history was positive for previous heart failure or infarction, the likelihood of death occurring in heart failure was not increased. The physical findings on admission revealed that 40 patients were in shock and 59 had some degree of congestive heart failure. These abnormalities had a striking effect on the mode of death, in that shock remained a prominent feature of the illness in the former group, whereas in the latter group the incidence of failure deaths was much greater than expected. The finding of ventricular irritability was associated with a rhythm death in 79 per cent of the cases. Electrocardiograms revealed no evidence of myocardial irritability in 63 patients, and no conduction abnormalities in 86. Nevertheless, over one half of these patients also died from an arrhythmia.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine