The coincidence of infarcts of the heart and brain an analysis

Summary

A STATISTICAL analysis of consecutive routine autopsy reports was carried out in an attempt to clarify the epidemiological and clinical importance of coincident cerebral and cardiac infarction. Three thousand five hundred and thirty two autopsies fulfilled our basic criteria, being performed on subjects over 20 years of age and dying from natural causes. These were examined and only those in whom macroscopic recent infarcts of the brain and heart were found were accepted for the study. Therefore only infarctions which could produce unambiguous clinical symptoms were analysed. Out of a total 906 infarctions 282 were cerebral alone, 532 cardiac alone and 92 coexisted in both the heart and brain.

The analysis recognised that the problem of combined infarction overlies two populations, namely patients dying from cerebrovascular disease and those dying from coronory heart disease. Its objectives were to ascertain if a large series of autopsies on such subjects would prove that there was an important and significant association between acute infarcts coinciding in the brain and the heart, and to examine the importance of age and sex. The association between cerebral and myocardial infarctions was highly significant (p<0.001) this being more marked in females. Analysis by age age cohorts showed that significance (P<0.001) was really confined to the decade 70–79 years with male predominance. Cardiac infarction alone was the most common lesion up to 80 years, after this age cerebral infarctions became predominant and combined lesions became infrequent.

We suggest that patients presenting wth a stroke in the decade 70–79 years should have the possibility of cardiac infarction fully investigated so that proper management A00IA200