Hypertension, diabetes mellitus, hypercholesterolemia, and smoking are known coronary risk factors. It has been our impression that premature graying of the hair also predisposes individuals to myocardial infarctions. To test this hypothesis, we evaluated all of the patients under the age of 50 who were admitted to the coronary care unit between 1974 and 1976 with a proven diagnosis of a myocardial infarction. There were 50 patients. Thirty-eight did not have premature graying. Twelve of the male patients (24%) had virtual total graying of the hair which made them appear older than their stated age. The graying in these patients started on the average at 29 years. Five of these patients state that other family members had premature hair graying. The incidence of diabetes, hypertension, and smoking was similar in those with and without premature hair graying. This preliminary study suggests that premature graying of the hair is associated with premature cardiovascular disease. It should probably be regarded as a coronary risk factor and used to identify patients at increased risk.

No abstract

There is no information on the effects of coffee on the human conduction system. His bundle electrograms were obtained in 12 patients before and 20 minutes after the ingestion of coffee containing 150 mg caffeine. Antegrade and retrograde refractory periods were obtained with the extrastimulus method. The effective and functional refractory period of the atrioventricular node decreased after coffee ingestion. This improvement in conduction is probably mediated by a release of catecholamines.

Levels of serum calcium, phosphorus, magnesium, SGOT, CPK, and LDH were measured in 61 patients admitted to a coronary care unit. In 34 the ECG and enzymes confirmed an acute myocardial infarction, whereas the remaining 27 did not have an acute myocardial infarction. The serum phosphorus declined significantly in those with the acute infarction compared to the control group. The fall was most marked in the third and fourth postinfarction day, and by the fifth day had returned to baseline values. The serum calcium and magnesium did not change significantly over the 5 days. Thus the fall in the serum phosphorus serves as a sensitive indicator of acute myocardial infarction.

The hemodynamic effects of intravenous morphine were documented by right heart catheterization in six patients with an acute uncomplicated transmural myocardial infarction one to three days after the onset of symptoms. Intracardiac pressures, brachial artery pressure, and cardiac output were determined before and 15 minutes after the termination of the morphine infusion. Five milligrams morphine was given intravenously over a 10-minute period. The brachial artery pressure fell from a mean of 78 to a mean of 73 mm Hg (NS). As a result or morphine administration, the average cardiac index decreased from 2.68 to 2.31 liters/min-m2 (P is less than 0.05), and the stroke index decreased from 27 to 22 ml/beat-m2 (P is less than 0.05). Only small changes were observed in the intracardiac pressures.