Clinical characteristics, electrocardiographic and enzyme correlations, and long-term prognosis of patients with chest pain associated with ST depression and/or T wave inversion.

The clinical characteristics, electrocardiographic changes, and long-term prognosis were studied in 50 patients suffering nontransmural myocardial infarctions. It is concluded that nontransmural myocardial infarcts tend to occur in older patients with known coronary atherosclerosis and these infarctions are frequently preceded by a period of unstable angina. The clinical course is often complicated with congestive heart failure and other major management problems. Three different groups of electrocardiographic changes were noted and all four in-hospital deaths showed the same pattern of electrocardiographic changes. The prognosis of patients suffering nontransmural myocardial infarctions is not good, as evidenced by a death rate similar to reported patients suffering transmural myocardial infarction and a significant incidence of cardiovascular disability in those who survive.