Danger of Rectal Examination in Patients with Acute Myocardial Infarction — Fact or Fiction?

Rectal examination is believed dangerous and is commonly deferred or omitted in patients with acute myocardial infarction. To evaluate the safety and specific usefulness in this clinical setting of an otherwise routine procedure, a gentle digital rectal examination was performed on 86 patients with acute myocardial infarction within 24 hours after admission to the hospital. No adverse clinical or electrocardiographic effects were observed, and no angina pectoris was produced. The unsuspected presence of fecal occult blood, prostatic enlargement and voluminous, hard stool was encountered frequently enough to make rectal examination a useful adjunct in planning of anticoagulation, bladder and bowel care for this patient group.