Document Detail


Management of acute myocardial infarction. Pathophysiological considerations.
MedLine Citation:
PMID:  1155244     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Development of improved techniques for assessing infarct size in intact experimental animals and in patients has made it possible to evaluate the effectiveness of selected interventions more objectively. It is becoming increasingly apparent that infarct size is an important determinant of prognosis. Experimentally, infarct size can be modified favorably under specified conditions by interventions designed to reduce myocardial oxygen requirements or increase myocardial energy supply during the early evolution of infarction. Preliminary clinical applications of these concepts have been encouraging. The time seems to be right for carefully controlled clinical investigations to determine whether techniques designed to protect ischemic myocardium will be effective in improving survival and reducing morbidity from acute myocardial infarction. On the basis of available evidence, it seems clear that appropriate management of patients with this disorder should include careful attention to the impact of any therapeutic modality on the heart itself. It does not suffice to treat patients with beta-adrenergic agonists simply because they may elevate systemic arterial blood pressure. Hemodynamics can not be the sole criteria in guiding the physician charged with the responsibility for patient management. Rather, he must consider the potential effects of any contemplated therapeutic modality on myocardial viability as well. The ultimate place if interventions designed to protect ischemic myocardium in the therapeutic armamentarium remains to be determined. However, judicious therapy should be designed to minimize myocardial oxygen requirements and maximize myocardial energy supply as well as to prevent criti l impairment of peripheral perfusion.
Authors:
B E Sobel
Related Documents :
7368944 - Effects of amitriptyline and clomipramine in the isolated, perfused rabbit heart.
3709234 - Changes in metabolite levels and morphology of teleost ventricular myocytes due to hypo...
7258094 - Effects of respiratory alkalosis on coronary vascular dynamics and myocardial energetic...
3920764 - Myocardial ischaemia during tachycardia--not due to an increase in myocardial oxygen de...
1263124 - Effect of age on the cardiotoxic action of digitalis.
6607664 - Preservation of interventricular septal function in patients having coronary artery byp...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Advances in cardiology     Volume:  15     ISSN:  0065-2326     ISO Abbreviation:  Adv Cardiol     Publication Date:  1975  
Date Detail:
Created Date:  1975-11-01     Completed Date:  1975-11-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0270063     Medline TA:  Adv Cardiol     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  99-110     Citation Subset:  IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adenosine Triphosphate / metabolism
Animals
Assisted Circulation
Cardiac Output
Coronary Circulation
Creatine Kinase / metabolism
Dogs
Heart / physiopathology
Heart Rate
Humans
Myocardial Contraction
Myocardial Infarction / mortality,  physiopathology,  therapy*
Myocardium / metabolism*
Oxygen Consumption*
Prognosis
Propranolol / pharmacology
Chemical
Reg. No./Substance:
525-66-6/Propranolol; 56-65-5/Adenosine Triphosphate; EC 2.7.3.2/Creatine Kinase

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


Previous Document:  Quantification of myocardial ischemic injury.
Next Document:  Structure and function of concanavalin A.