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Late Complications of Myocardial Infarction

Richard S. Cosby, MD; John A. Giddings, MD; Jackie R. See, MD; Mary Mayo
JAMA. 1976;236(15):1717-1720. doi:10.1001/jama.1976.03270160039027.
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RECOGNITION of the late complications of myocardial infarction necessitates a morphologic approach, a recognition that the pumping action of the heart is importantly affected by asynergy, aneurysm, or papillary muscle dysfunction,1,2 and the assumption that such abnormal morphology can be recognized and quantitated. Thus, congestive heart failure or dysrhythmias during acute infarction may be followed weeks or months later by recurrent pump failure. Simple description of the coronary tree, eg, critical stenosis of one, two, or three vessels, may be a wholly inadequate description of postinfarction status. It is the purpose of this review to examine the factors leading to the recognition and treatment of late complications in myocardial infarction and to attempt a separation of high- and low-risk groups.

Table 1 lists major and minor late complications, ie, those arising after the 14th day, in 100 patients with acute transmural myocardial infarction. Table 2 lists the frequency of


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