The pre-hospital phase of acute myocardial infarction and sudden death. I. Prodromata of Acute Coronary Events

The definition of a recognizable prodromal syndrome in myocardial infarction (MI) and sudden death (SD) could have important implications for clinical practice. Data concerning possible prodromata experienced by patients hospitalized with acute MI or dying suddenly in Framingham, Massachusetts, were collected for a 10-month period. In addition, identical interviews were conducted with ambulatory subjects undergoing routine examination and patients with acute noncoronary illnesses. Seventy percent of MI patients had chest discomfort in the preceding 2 months. More frequent among those dying suddenly were a variety of nonspecific symptoms. Symptoms were several times more frequent in patients than in the comparison group. In the high-risk patient, identification of even relatively nonspecific prodromal symptoms may be of use in identifying a subgroup at higher risk and in facilitating early hospitalization in the event of an acute attack.