J. Richard Durham, M.D.
JAMA. 1954;155(9):826-827. doi:10.1001/jama.1954.03690270022007.
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The increasing use of routine electrocardiograms in clinical and industrial medicine and the physician's awareness of the existence of coronary disease has resulted in the recognition of a prodromal stage or "incubation" period for acute myocardial infarction—a period that may last as long as several weeks and during which time no test may give objective evidence of coronary disease or presage the inevitable infarction to come.

Gilson and Day1 have suggested the term latent myocardial infarction to describe this period. Their five cases, however, all showed ischemic patterns prior to the infarction, and they believed that these cases might fall within the classification of coronary failure so well described by Freedberg and others.2 Hecht3 stated that uniform ischemia of all muscle layers or ischemia localized to an intramural area surrounded by well-functioning muscle may give no electrocardiographic changes. It is a well-recognized fact that the electrocardiogram may


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