Left ventricular function and prognosis in patients suspected of acute myocardial infarction but without confirmed diagnosis. The risk of cardiac events related to echocardiography, systolic time intervals, and chest x-ray.

The prognosis following discharge, with cardiac events as endpoint, was related to left ventricular function in 217 patients admitted with a suspicion of acute myocardial infarction (AMI), but in whom the diagnosis was not confirmed (non-AMI patients). The investigations used were echocardiography, systolic time intervals, and chest X-ray. During follow-up (median 14 months, range 12-24 months), 18 cardiac events occurred, i.e. non-fatal AMI or cardiac death. The prognosis for non-AMI patients was only slightly better than for patients with confirmed AMI (p = 0.05). The prognosis for non-AMI patients was significantly related to a decreased left ventricular function. Measurements of relative heart volume or mitral septal separation on echocardiography gave significant information about prognosis. The percentage without cardiac events after one year was 88.0 in patients with cardiomegaly versus 96.8 in those with normal heart size (p = 0.029). We conclude that non-AMI patients with decreased left ventricular function are at increased risk of cardiac events following discharge.