The Myth of Acute "Mild" Myocardial Infarction

Patients with acute myocardial infarction and an uncomplicated early clinical course are often thought to have suffered a mild myocardial infarction. There is also a tendency to link ECG changes suggestive of nontransmural necrosis with such a benign clinical course. Recent work proves that such patients have the same short- and long-term prognosis, similar angiographic and hemodynamic patterns, and deserve management identical to that for patients with transmural myocardial infarction. It is hoped that by combining the older modalities with new diagnostic methods it will be possible to quantitate the magnitude of old and new myocardial ischemic necrosis on which prognosis to a great extent is based.