Inferior wall myocardial infarction preceded by acute exudative pharyngitis in young males

We conducted a comparative study in an intensive coronary care unit to elucidate the role of acute exudative pharyngitis in the setting of acute myocardial infarction (AMI). The subjects were 42 young male patients with AMI that was preceded by pharyngitis in 7 of them. Results showed that the site of the infarction was inferior in all those with preceding pharyngitis while only 33% of the other group had an inferior infarction. In patients with preceding exudative pharyngitis the coronary event was the first and only confrontation with the disease. Their prognosis was good, with normal exercise tests and absent coronary risk factors except for smoking in two patients and family history in one. Patients without pharyngitis had multiple coronary risk factors, with positive exercise stress tests in 46% and recurrent infarctions in 26%. Coronary arteriography was performed in four patients with pharyngitis and was normal, while multi-vessel disease was the rule in those without pharyngitis. We conclude that exudative pharyngitis may be followed by acute inferior myocardial infarction in young males and the diagnosis of infarction should be ruled out when such patients present with chest pains.