Acute Myocardial Infarction in Patients Thirty-Five Years of Age and Under

¹ Norfolk, Virginia

A series of 59 cases of clinically proved myocardial infarction in patients 35 years of age and under has been presented and the literature on the subject of myocardial infarction in patients under the age of 40 reviewed.

The group consisted of 46 white men of whom 12 (26 per cent) died; four white women of whom two (50 per cent) died; five Negro men of whom four (80 per cent) died; and four Negro women of whom four (100 per cent) died.

Hypertension was noted in 34 per cent of the cases. Diabetes mellitus was noted in 18 per cent, and obesity was a factor in 27 per cent of the cases. Elevated serum cholesterol (above 250 mg/100 ml) was noted in 84 per cent of the cases with a range of 191 to 460 mg/100 ml, or an average of 297 mg/100 ml.

Necropsy in 17 (77 per cent) of the 22 deaths revealed a predominant involvement in the left anterior descending coronary artery.

Electrocardiographic infarction pattern was found to be as frequently anterior as posterior in distribution with lateral extention about half as frequent.

There is no question that myocardial infarction is a more severe and devastating disease in the overall younger age groups than in the older age groups, the current study having shown a 24 per cent instant mortality. The mortality in white women is higher than that of white men, although the incidence of the disease is less. The incidence of the disease in the Negro is almost equal in men and women, but the mortality rate in the Negro, particularly women, approaches 100 per cent.