Detection and Evaluation of Myocardial Infarction by Image Amplification and Cinefluoroqraphy

Radiological abnormalities in patients who have survived a myocardial infarction. Their possible relationship to aneurysm formation.

“…The site of 16 out of 20 of the bulges and areas of abnormal pulsation corresponded to the electrocardiographic site of the infarct. This is contrary to the experience of Kurtzman and Lofstrom (1963) who found a poor correlation between the location of the myocardial infarction electrocardiographically and the area of abnormality seen fluoroscopically. We feel that the bulges, at least, indicate aneurysm formation (Holmes and MacFadyen, 1964) but admit that a prolonged follow up will be necessary for final evaluation.…”

“…It is evident that more abnormalities would be defined if cinefluorograph records were made (Kurtzman and Lofstrom, 1963). We agree with those authors that such studies are valuable in the assessment of myocardial infarction and we intend to follow up this group of patients over a prolonged period in order to answer some of the problems raised in this paper.…”

“…It is admitted that this observation is a subjective one, but it is likely that abnormal pulsations occur more frequently than we have been able to record (Kurtzman and Lofstrom, 1963). An area of abnormal pulsation was seen in 5 patients in our group, 4 on the anterior heart border and the other at the apex of the heart.…”

Cardiac aneurysm after myocardial infarction

“…The incidence of aneurysm in autopsy reports of patients after a myocardial infarction has varied from 3 % (Dubnow, Burchell & Titus, 1965) to 38% (Parkinson, Bedford & Thomson, 1938). The diagnosis is rarely made in life although Master et al (1940) found abnormalities of pulsation of the cardiac contour after myocardial infarction in 73 % and Kurtzman & Lofstrom (1963) in 78% of patients. Not all of these patients had aneurysms but recently Gorlin, Klein & Sullivan (1967) demonstrated twenty-four cases of aneurysm by left heart angiography, in a series of 100 patients with coronary artery disease, and two of the present authors (Groden & James, 1968) have found radiological features suggestive of aneurysm in 20% of patients who had survived a myocardial infarction more than 3 months previously.…”