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Published on: December 11, 2016
Clinical and necropsy findings in patients with calcified myocardial infarcts
Craig Steven Cameron1, William Clifford Roberts
1Division of Cardiology, Department of Internal Medicine, Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, Texas 75246, USA.
Insights
Patients with calcified myocardial infarcts are typically men who experience their first infarct young. Chronic heart failure is common, often leading to death, with dilated left ventricles and increased heart weight being frequent findings.
Area of Science:
- Cardiology
- Pathology
Background:
- Myocardial infarcts can calcify, leading to long-term cardiac complications.
- Understanding the characteristics and outcomes of patients with calcified myocardial infarcts is crucial for clinical management.
Purpose of the Study:
- To describe the clinical and necropsy findings in patients with grossly visible myocardial infarcts.
- To analyze patient demographics, infarct characteristics, and causes of death.
Main Methods:
- Retrospective analysis of clinical and necropsy data from 37 patients with calcified myocardial infarcts.
- Examination of patient age at first infarct, time to death, cardiac morphology, and cause of death.
Main Results:
- The study included 31 men and 6 women, with the first infarct occurring at a mean age of 50 years.
- Chronic heart failure was prevalent (73%) and the most common cause of death.
- Dilated left ventricular cavities (nearly all patients), left ventricular aneurysms (43%), and increased heart weight (94%) were common.
- Severe coronary arterial atherosclerosis was present in all patients.
Conclusions:
- Calcified myocardial infarcts predominantly affect men, often occurring at a relatively young age.
- These infarcts are frequently associated with aneurysmal changes, dilated left ventricles, and increased heart weight.
- Heart failure is the main clinical manifestation and the most common cause of mortality in these patients.
Abstract:
Clinical and necropsy findings are described in 37 patients with grossly visible myocardial infarcts. At the time of the first infarct, the 31 men ranged in age from 25 to 72 years (mean, 47) and the 6 women, from 50 to 70 years (mean, 56). The interval from the first clinically apparent acute myocardial infarct to death varied from 2 to 28 years (mean, 13) and was >or=10 years in 24 of 32 patients (75%) for whom this information was available. The ages of death in the 31 men ranged from 39 to 75 years (mean, 61), and in the 6 women, from 62 to 75 years (mean, 69). The ages of death in the 9 patients having coronary bypass grafting was insignificantly different from that in the 28 patients not having this procedure. Most had chronic heart failure (73%), which was the most common mode of death. Nearly all had dilated left ventricular cavities, with left ventricular aneurysms in 43%. The hearts were increased in weight in 94%, and all had severe coronary arterial atherosclerosis. Thus, patients with calcified myocardial infarcts are usually men, the infarct that calcifies usually occurs at a relatively young age (mean, 50), the calcified wall is often aneurysmal, the left ventricular cavity is almost always dilated, the heart weight is increased, and heart failure is the predominant symptom and most common mode of death.
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