INFERIOR WALL MYOCARDIAL-INFARCTION PRECEDED BY ACUTE EXUDATIVE PHARYNGITIS IN YOUNG MALES

We conducted a comparative study in an intensive coronary care unit to elucidate the role of acute exudative pharyngitis in the setting of a cute myocardial infarction (AMI). The subjects were 42 young male pati ents with AMI that was preceded by pharyngitis in 7 of them. Results s howed that the site of the infarction was inferior in all those with p receding pharyngitis while only 33% of the other group had an inferior infarction. In patients with preceding exudative pharyngitis the coro nary event was the first and only confrontation with the disease. Thei r prognosis was good, with normal exercise tests and absent coronary r isk factors except for smoking in two patients and family history in o ne. Patients without pharyngitis had multiple coronary risk factors, w ith positive exercise stress tests in 46% and recurrent infarctions in 26%. Coronary arteriography was performed in four patients with phary ngitis and was normal, while multi-vessel disease was the rule in thos e without pharyngitis. We conclude that exudative pharyngitis may be f ollowed by acute inferior myocardial infarction in young males and the diagnosis of infarction should be ruled out when such patients presen t with chest pains.