Search

Ninety-eight patients with acute myocardial infarctions (heart attacks) were examined independently by 3 clinicians to determine the percentage of blood emptied from the right and left lower heart chambers during contraction (right and left ventricle ejection fractions). Ejection fractions were classed as normal, slightly reduced, moderately reduced, or severely reduced. Patient records, physical examinations, chest x-rays, and electrocardiographs (measurements of the electrical output of the heart) were used to evaluate the patients. There were numerous discrepancies between the actual status of the patients and the clinicians' assessment, as well as among the clinicians themselves. Several indexes traditionally thought to be reliable indicators of ejection fractions were evaluated, including previous heart attack, location of infarct as determined by electrocardiography, and physical signs of heart failure. Many of these indexes did not accurately predict a reduction in ventricular function.