A NOTE ON CORONARY OCCLUSION AND MYOCARDIAL INFARCTION FOUND POST MORTEM AT THE MASSACHUSETTS GENERAL HOSPITAL DURING THE TWENTY YEAR PERIOD FROM 1926 TO 1945 INCLUSIVE

Abstract

An analysis of the postmortem records of the Massachusetts General Hospital over a period of 20 yrs. (7,018 cases) has revealed an increasing incidence of the diagnosis of coronary occlusion and myocardial infarction from a very low figure in 1926 to percentages of 13 to 14 in 1940 and 1941; a change to be attributed in part at least to a more active search for these lesions. Occlusion of the left coronary artery, involving preponderantly the anterior descending branch, was much more common, especially in the chronic stage, than occlusion of the right coronary. Anterior myocardial infarcts, both recent and healed, were nearly twice as common as posterior myocardial infarcts; not infrequently one was superimposed on the other, i.e., a fresh lesion in a heart with an old scar. The anterior myocardial infarcts were somewhat more serious than the posterior; this was particularly shown in the case of ruptures of the heart which occurred through the anterior wall in 22 of the 23 cases. Coronary occlusion and myocardial infarction did not always coincide and should not be considered as synonymous.