Symptoms, disablement and treatment during two years after myocardial infarction

Invalidism after myocardial infarction was elucidated by assessing chest pain, dyspnoea, need for cardiac medication, and the extent to which patients returned to work during the first two years after myocardial infarction. The patients in the study were obtained from the Myocardial Infarction Register in Göteborg and were followed at the Post-MI Clinic. Standardized criteria were used for handling of symptoms, signs, risk factors and complications. The prevalence of various symptoms was registered at regular intervals and the findings at 3 months and one year infarction are presented. The prevalence of symptoms was determined by means of questionnaires. Three months and one year after infarction the prevalence of effort-induced chest pain was 53 and 44%, respectively. There was no age correlation. The comparable figues for dyspnoea on exertion were 47 and 41%, respectively. The proportion of patients with dyspnoea tended to rise with increasing age. Dyspnoea on exertion was more prevalent at 3 months than at 12 months after infarction. About 60% of the patients had experienced some of the symptoms before acute infarction and this proportion increased to about 70% during the follow-up period. This rise is caused by an increase of patients with solitary dyspnoea. Only a few patients received treatment with digitalis and diuretics prior to onset of symptoms. Three and 12 months after infarction the prevalence of patients treated with digitalis was 36 and 39%, respectively. The corresponding figures for diuretics were 15 and 20%, respectively. Both digitalis and diuretic therapy were more frequent at 12 months than at 3 months after infarction. Diuretic therapy increased significantly with age. Three months after infarction 17% of the patients were back at work. After 12 and 24 months the corresponding figures were 63 and 70%, respectively. The tendency for resumption of work at all intervals during the follow-up decreased with advancing age. During the first year after myocardial infarction 30% of the patients were readmitted to hospital. The chief reason for readmission to hospital was suspected (but later not verified) reinfarction.