Showing papers by "Patricia M. McNamara published in 1973"
TL;DR: Unrecognized myocardial infarction appears to be as prevalent in the 1970's as it was in the 1950's, and the reasons for this prevalence and possible solutions to the problem are discussed.
Abstract: The occurrence, prognosis and characteristics of persons with nonfatal unrecognized myocardial infarction were studied prospectively in a population of 5,127 men and women followed up biennially for 18 years. Of 259 electrocardiographically documented myocardial infarctions, 60 (23 percent) were discovered only by routine electrocardiogram at the time of biennial examination. Of these unrecognized infarctions, 32 (53 percent) were actually silent. In the other 47 percent of cases, the patients gave a history of interim symptoms judged to be compatible with acute infarction. In addition, of the 32 patients judged to have a silent infarction, 22 reported interim illnesses that could have been compatible with myocardial infarction. Only 10 of the 60 patients (17 percent) reported no interim illnesses or symptoms. Of the 28 patients with symptomatic infarction, 6 (21 percent) did not visit their physician despite severe symptoms; 20 gave a history of interim chest pain, 1 a history of epigastric pain and 7 a history of severe dyspnea. Patients who subsequently had unrecognized myocardial infarction typically visited physicians infrequently. Unrecognized myocardial infarction was distinctly rare in patients with prior angina pectoris. Patients with prior diabetes or high blood pressure appeared more likely to have unrecognized infarction. Unrecognized myocardial infarction appears to be as prevalent in the 1970's as it was in the 1950's. The reasons for this prevalence and possible solutions to the problem are discussed.
361 citations
26 citations
TL;DR: All diabetics manifested a decidedly increased incidence of atherosclerotic cardiovascular disease regardless of the type of treatment followed, and in both sexes, the percent of excess risk was most pronounced for IC.
Abstract: Publisher Summary This chapter discusses cardiovascular complications in diabetics. Patients with diabetes mellitus tend to suffer unduly from premature and severe atheromatosis. Some evidence suggests that by the time diabetes is first diagnosed, the patient has already developed an increased tendency to develop coronary artery disease. In a study described in the chapter, diabetics suffering from coronary heart disease (CHD), cerebrovascular accidents, and intermittent claudication (IC) were evaluated. All diabetics manifested a decidedly increased incidence of atherosclerotic cardiovascular disease regardless of the type of treatment followed. In both sexes, the percent of excess risk was most pronounced for IC. Mean serum cholesterol levels were no higher in diabetic men but were slightly higher in diabetic women than in the total study group. The mean prebeta–lipoprotein fraction in diabetics was substantially elevated in both sexes. Blood pressure was found to be significantly higher than in the population as a whole. Relative weight was also considerably higher in diabetics of both sexes. The abnormal percentage for most parameters in both men and women was higher in diabetics than in the controls, and the disparity tended to be more apparent in women than in men.
21 citations