Premonitory symptoms and stress factors preceding sudden death from ischaemic heart disease.
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Biomedical subjects
Publications and source records attributed to M Romo.
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The association of meterological factors with acute myocardial infarction was studied within a one-year period in Helsinki. Seasonal variation was found with the lowest incidence in summer and the highest in late autumn. Environmental temperature was not significantly correlated with the incidence of myocardial infarction but the case fatality rate was higher on coldest days. Atmospheric pressure turned out to be the meteorological variable with the highest correlation with the occurrence of myocardial infarction. Rapid decrease in atmospheric pressure was also associated with increased incidence of acute myocardial infarction. Relative humidity had little independent effect. The weather types with highest and lowest risk of heart attack were determined by the combined use of factor and cluster analysis. The most unfavourable turned out to be a relatively cold and moist weather with low atmospheric pressure, common in Helsinki during early winter and late autumn. The incidence of infarction did not increase on typical cold and dry winter days. The most favourable weather was warm, dry and stable summer weather. The difference in incidences between most and least favourable weather types was three-fold.
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UNLABELLED: All cases of acute myocardial infarction (AMI) and sudden death due to coronary heart disease have been registered in two Swedish and two Finnish cities during a 1-year period. The incidence increased steeply with age in both sexes and was in all age groups far higher in males than in females. The age-related incidence in both Finnish cities was definitely higher than in Gothenburg, Sweden, while the other Swedish register city, Boden, had an intermediate position. THE CASE: fatality rate within one year was 44.2% for males and 37.4% for females. This difference was already apparent in the first hour after the onset of the attack, when the case: fatality rate was 15.5% for males and 9.3% for females. A history of previous cardiovascular disease was much more common in AMI patients than in the general population. It was also slightly more common in subjects who died suddenly than in AMI patients who did not die suddenly.
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Deaths from ischemic heart disease(IHD) occurring during a period of one year in Helsinki in persons aged 65 years or younger have been investigated by the Ischaemic Heart Disease Register. Altogether 526 fatalities were registered. Autopsy data were collected in 432 cases, the autopsy rate being 82 percent. The results are presented separately for persons autopsied in the pathologic departments, representing mostly delayed deaths in hospitals, and for medico-legally autopsied persons representing sudden deaths outside hospitals. The diagnosis of IHD death was either based on the positive patho-anatomic or clinical evidence of an acute heart attack or supported by a history of clinical IHD in 92 percent of all registered fatal cases. In the remaining fatalities the possibility of other causes of death had been more or less definitely excluced. All persons with an acute attack of IHD and all autopsied cases showed a division into four socio-economic groups very similar to that of the population of Helsinki. Men belonging to the lowest social group were over-represented among medico-legally autopsied cases. A history of a previous heart disease, visits to a doctor and the use of digitalis were less common in persons autopsied medico-legally than in those autopsied in the pathologic departments. In the former an acute infarction was most often located in the posterior wall and in the latter in the anterior wall of the left ventricle. The prevalence of an occlusion was highest in the right coronary artery in the former and in the left anterior descending coronary artery in the latter; In medico-legally autopsied cases in which a recent myocardial infarction was observed the interventricular septum was involved in 81 percent, but in cases with an old infarction the septum was involved in only 52 percent. No difference in the size of the hearts, the frequency of an old infarction or the prevalence of coronary occlusions was found between persons autopsied in the pathologic and forensic departments. Although a previous angina was about equally common in both sexes, old infarctions were more common in men. The increase in heart weight had occurred proportionally to the same extent in both sexes.