An acute myocardial infarction may be "silent" in some patients.


(1) new pathologic Q wave or QS complexes in the ECG

(2) no signs or symptoms of an acute myocardial infarction

(3) exclusion of incorrect lead placement or QRS confounders

(4) exclusion of a coronary revascularization procedure as cause


Sheifer et al found that unrecognized myocardial infarction in the elderly was associated with:

(1) absence of angina symptoms

(2) absence of congestive heart failure (CHF)

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