COMPARISON OF CLINICAL AND PATHOLOGIC ASPECTS OF CORONARY ARTERY DISEASE IN MEN OF VARIOUS AGE GROUPS: A STUDY OF 950 AUTOPSIED CASES FROM THE ARMED FORCES INSTITUTE OF PATHOLOGY

Abstract

47% of the cases occurred under the age of 40 and 12% under the age of 30 yrs. White were more liable to coronary thrombosis than negro soldiers. Hypertension did not appear to be an important factor in the under-40 group. The coronary attack came on more frequently during strenuous activity in the young group, while over the age of 40 there was a higher incidence of premonitory symptoms or previous manifestations of coronary artery disease. The 1st attack was more frequently fatal in men under 40. Myocardial scarring increased with age, and congestive failure from ischemic heart disease was commoner in the older group. Rhythm and conduction disturbances in the ecg. increased with age. Thrombotic occlusion of the coronary vessels was the rule in the under-40 group, while over this age arteriosclerotic narrowing complicated the picture. Mural thrombi, myocardial fibrosis, ventricular aneurysm, and pericarditis in association with recent infarction were all found with greater frequency with advancing age. Non-cardiac infarcts also increased with advancing yrs. Most subjects with pulmonary infarcts did not have mural thrombi on the right side of the heart. In general, the prognosis of coronary artery disease under the age of 40 would appear to be worse than in men aged 40 and over.