Initial presentation of acute myocardial infarction and the relation to short-term clinical course

To be able to predict the clinical course of an acute myocardial infarction (AMI) at the first visit to the patient would be of great importance to a general practitioner considering home treatment for this disease. Therefore, we have analysed the presenting signs and symptoms and their relation to the course in 53 patients with AMI. Twenty-seven of the patients had an uncomplicated course, while 26 suffered continuous pain, cardiac failure, arrhythmias, or death during their hospital stay. The presenting signs and symptoms were remarkably similar in the two groups, the only significant difference being a higher incidence of abnormal pulse rate in the group with complications. We conclude that the initial presentation of AMI does not reliably predict later occurrence of complications. Doctors who want to treat patients with AMI at home must take this uncertainty into consideration.