There is no condition in which it is more difficult to foretell the future than coronary artery disease. Analyses of large series do not help in the individual case but statistics do, of course, give some guidance, particularly as regards complicating factors. Angina from syphilitic aortis or aortic stenosis has a more serious prognosis.
Some 25% of individuals die within four weeks of myocardial infarction, mostly within 48 hours. Astudy of various statistical surveys on the mortality of myocardial infarction suggests that following recovery from acute attack 20% will die within a year, 30%, within five years and 70% within 10 years. Thus the prognosis is not so gloomy as sometimes thought. Mortality increases with age, a past history of myocardial infarction, prolonged pain, cardiac failure, shock, arrhythmias or embolism. The prognosis of patients with angina pectoris from coronary atherosclerosis has been shown to be very similar to that of patients who survive a first attack of myocardial infarction. The prognosis is likely to be better if the patient accepts advice in regard to giving up smoking and takes regular moderate exercise, reduces excessive weight and, if hypertension is found, receive the appropriate treatment.
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