Calcification of healed myocardial infarcts

Clinical and necropsy findings are described in 21 patients, aged 43 to 78 years (mean 63) (19 men [90%]), who had grossly visible calcified myocardial infarcts. The interval from the first clinically apparent acute myocardial infarct to death (20 patients) ranged from 2 to 26 years (mean 12). This interval was greater than 5 years in 17 patients (85%) and greater than 10 years in 11 patients (55%). The ages at the first clinically apparent acute myocardial infarct ranged from 36 to 72 years (mean 51). Of the 21 patients, 17 (81%) had clinical evidence of chronic congestive heart failure; 12 (57%) had left ventricular aneurysms; 8 (38%) had documented episodes of ventricular tachycardia; and 5 had angina pectoris. At necropsy, the heart weight was increased (greater than 400 g) in all (mean 557 g), the left ventricular cavity was dilated in all, and at least 1 and usually 2 or 3 (86%) major epicardial coronary arteries were narrowed greater than 75% in cross-sectional area by atherosclerotic plaque. Thus, patients with calcified myocardial infarcts are usually men, they usually have a myocardial infarct that calcifies at a relatively young age, the calcified wall is usually part of an aneurysmal wall, the left ventricular cavity is almost always dilated, heart weight is increased, and progressive congestive heart failure is the usual mode of death.