Cerebrovascular incidents after myocardial infarction.

Abstract

Pathological studies show a high correlation between the degree of atheroma in coronary, cerebral and carotid arteries. Necropsy evidence of myocardial infarction also shows a high prevalence of severe atheroma in the carotid arteries. A further pathological finding is that obstruction in cerebral and carotid circulations is commonly due to embolism from the heart. Long-term follow-up of survivors of myocardial infarction indicates a low prevalence of cerebrovascular disease. To test if this low prevalence is due to lack of clinical ascertainment, 260 survivors of myocardial infarction were followed for 5 yr. Specific attention was given to eliciting any clinical manifestations of cerebrovascular disease. In survivors of myocardial infarction the prevalence of cerebrovascular disease is surprisingly low: completed strokes 4%, transient cerebral ischemic attacks 2%. A possible explanation of the low prevalence is that after the acute episode of myocardial infarction, attacks of cardiac dysrhythmia predisposing to systemic embolism become infrequent.