[The prodromal phase of myocardial infarction (author's transl)]

The prodromal phase was studied retrospectively in 101 patients who had sustained acute myocardial infarctions. Only in a few did the infarction occur suddenly. Prodromal symptoms occurred in 80%: angina pectoris of various forms, especially change in type of complaint, signs of heart failure and non-specific general symptoms. With approaching infarction, approximately from the third week onwards, there was a crescendo course of anginal symptoms and of heart failure. Especially typical was change in the form of the angina, with occurrence of spontaneous or resting angina or recumbent angina. Such anginal symptoms, without previous angina on effort, only occurred during the last seven days before the infarction. Angina with manifest or latent signs of heart failure in the course of increasing symptoms (crescendo course) was typical for the last three to four days before infarction. There was an increased incidence of prodromal signs in anterior-wall infarction. A crescendo course implied a worse prognosis. Prodromal symptoms are frequent and prognostically less favourable also in women.