Painless myocardial infarction in diabetes mellitus--a myth?

One hundred and ten consecutive diabetic patients with acute myocardial infarction (AMI) were compared to a matched group of non-diabetics with AMI, and the pain experienced during the acute episode by each patient was estimated by counting the number of morphine injections given. No significant difference was found regarding the frequency of painless infarctions, the distribution of injections given during the first three days in the coronary unit, or the need for injections after that time. We conclude that contrary to the common supposition, painless AMI in hospitalised patients is almost as frequent among nondiabetics as among diabetics.