Document Detail


Hemodynamically complicated ST-segment elevation myocardial infarction: presentation and treatment.
MedLine Citation:
PMID:  20932109     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
When ST-segment elevation myocardial infarction is complicated by hemodynamic instability, clinical evaluation alone cannot be relied upon for accurate assessment. Invasive hemodynamic monitoring with a pulmonary artery catheter and intra-arterial catheter should, therefore, be performed to gauge impaired hemodynamics in such patients and make necessary changes in therapy. There are several hemodynamic disturbances that can occur after ST-segment elevation myocardial infarction including pulmonary congestion, cardiogenic shock and mechanical complications such as left-ventricular free-wall rupture, ventricular-septal defect or papillary muscle rupture. Patients with hemodynamic compromise should be admitted to the coronary care unit and therapy should be initiated with drugs such as vasodilators, diuretics and positive-inotropic agents, based on hemodynamic data provided by the invasive catheter. Intra-aortic balloon counterpulsation should be used for those who fail to achieve hemodynamic stability with medical therapy. Coronary angiography should be considered for all patients who are hemodynamically unstable provided they are candidates for aggressive care, followed by coronary revascularization in those with suitable anatomy. Operative repair should be performed promptly when a surgically correctable mechanical lesion is identified.
Authors:
Amit Kumar
Related Documents :
17285449 - A case of takotsubo cardiomyopathy associated with epileptic seizure: reversible left v...
1453539 - Pathogenesis, treatment and prognosis of impending myocardial infarction and early post...
10695469 - Ventricular fibrillation in a patient with prominent j (osborn) waves and st segment el...
3920889 - Coronary artery spasm after abrupt withdrawal of nitroglycerin in rabbits.
7932069 - Different clinical implications for st depression and t wave inversion in non-q wave my...
20954789 - Isolated inferior wall st segment depression as an early sign of acute anterior wall my...
10639269 - The essence trial: efficacy and safety of subcutaneous enoxaparin in unstable angina an...
49229 - Multiform ventricular ectopic rhythm. evidence for multiple parasystolic activity.
12683559 - Early and late arrhythmias in patients in preoperative sinus rhythm submitted to mitral...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Future cardiology     Volume:  6     ISSN:  1744-8298     ISO Abbreviation:  Future Cardiol     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-10-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101239345     Medline TA:  Future Cardiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  591-602     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Medicine, Lahey Clinic, Burlington, MA 01805, USA. amkrdoc@gmail.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Statin loading before percutaneous coronary intervention: proposed mechanisms and applications.
Next Document:  Screening value of N-terminal pro-B-type natriuretic peptide as a predictor of perioperative cardiac...