[Current causes of mortality in acute myocardial infarction]

The mortality rate of acute myocardial infarction (AMI) has decreased from 50% in 1926 to 9% nowadays. The reason for this change has been the development of coronary care units, the use of new inotropic agents, antiarrythmic drugs, pacemakers, as well as the better knowledge of the right ventricular infarction and heart failure. We studied 100 fatal AMI (group II) out of 1187 patients admitted to the Instituto Nacional de Cardiologia "Ignacio Chávez" CCU up to august 1987 and compared them with 500 survivors of acute coronary occlusion in the same period., (group I) - In both groups there were more men between 50 and 70 years. Females older than 60, had a higher mortality rate. Twenty patients died with clinical evidence of tamponade, five of them had left ventricular rupture at autopsy. The fatal AMI group had higher rates of past history of myocardial infarction, also higher rates of persistent angina, myocardial re-infarction, 3er degree AV block and RBBB. The more frequent causes of death were grade III-IV heart failure and left ventricular wall rupture.