A comparison of nontransmural and transmural myocardial infarction.

This report compares the past history, hospital course and follow-up of 70 patients with nontransmural myocardial infarction compared to 259 patients with transmural myocardial infarction. The pre-infarction history in the two groups is similar with respect to angina and infarction. The hospital course for non-transmural myocardial infarction is not a guide for future cardiac events and the post-hospital prognosis in the two groups is similar. Nontransmural myocardial infarction has a lower hospital mortality (P less than 0.05). Patients in whom nontransmural myocardial infarction is a first coronary event have a lower incidence of subsequent angina (P less than 0.05). The study demonstrates that myocardial infarction without development of q waves does not have an unfavourable long term outlook when compared to transmural infarction. This finding is contrary to reports which suggest a poor prognosis and recommend early coronary anteriography with a view to aorto-coronary bypass in patients with nontransmural infarction.