CHEST PAIN IN EARLY RECOGNITION OF LARGE INFARCTS

Abstract

Among 90 patients with a diagnosis of 1st myocardial infarction consistent significant associations were found between pain duration, increase in concentration of serum glutamic oxaloacetic transaminase (SGOT), maximum temperature and type of infarct (transmural or nontransmural). The infarct size may be associated with pain duration, increase in SGOT concentration and maximum temperature, and that patients with transmural infarcts have larger infarcts than those with nontransmural infarcts. A higher incidence of premonitory pain, in particular, premonitory rest pain, was noted in patients with transmural infarcts, who also had a significantly higher leukocyte count than patients with nontransmural infarcts. Pain intensity was also found to be associated directly with increase in SGOT concentration. Because intergroup differences were not significant consistently, the association between infarct size, premonitory pain, pain intensity and leukocytosis is less certain. If the association between pain duration and infarct size is confirmed, a simple means would be available for the early recognition of the patient with a large infarct and adverse prognosis who would benefit from prompt therapeutic measures to reduce infarct size.