Clinical and necropsy findings are described in 37 patients with grossly visible myocardial infarcts. At the time of the first infarct, the 31 men ranged in age from 25 to 72 years (mean, 47) and the 6 women, from 50 to 70 years (mean, 56). The interval from the first clinically apparent acute myocardial infarct to death varied from 2 to 28 years (mean, 13) and was >or=10 years in 24 of 32 patients (75%) for whom this information was available. The ages of death in the 31 men ranged from 39 to 75 years (mean, 61), and in the 6 women, from 62 to 75 years (mean, 69). The ages of death in the 9 patients having coronary bypass grafting was insignificantly different from that in the 28 patients not having this procedure. Most had chronic heart failure (73%), which was the most common mode of death. Nearly all had dilated left ventricular cavities, with left ventricular aneurysms in 43%. The hearts were increased in weight in 94%, and all had severe coronary arterial atherosclerosis. Thus, patients with calcified myocardial infarcts are usually men, the infarct that calcifies usually occurs at a relatively young age (mean, 50), the calcified wall is often aneurysmal, the left ventricular cavity is almost always dilated, the heart weight is increased, and heart failure is the predominant symptom and most common mode of death.