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The management of patients who present with a myocardial i nfarcti on has altered radi ca lly over the past two decades. The expansion of knowledge relating to the epidemiology of the condition together with a greater understanding of the causes of the early mortality from it have resulted in major changes in the way these pati ents are treated duri ng the acute phase of the illness. The deve 1 opment of 'dedi cated' Coronary Care Units in hospitals and the recogni ti on of the need for ' Mobile Coronary Care Units' in the cOl1Ul1unity have made a major impact upon the early mortality from myocardial infarction. Over the past decade, a great deal of attention has been paid to strategies designed to limit the size of a myocardial infarct. As an extensi on of thi s approach, the 1980' s have seen the evo 1 uti on of techniques for revascularization of ischemic tissue. All these procedures while appearing to hold the promise of reducing the acute mortality from myocardial infarction, create the need for a planned approach to the long term management of these patients. While there are some modest i ndi cati ons that coronary atherosc 1 erosi s coul d be arrested or even reversed, for all practical purposes it remains a chroni c progressi ve di sease.
Sommario
1. Introduction: Long-Term Management of Patients After Myocardial Infarction.- I. Patterns Of Coronary Artery Disease And Survival.- 2. Changing Patterns in the Epidemiology of Coronary Artery Disease: Trends in Survival After Myocardial Infarction.- 3. Trends in Pre-Hospital Mortality.- 4. Hospital and Post-Hospital Mortality After Myocardial Infarction.- II. Assessment Of Function.- 5. Physiological Response to Exercise.- 6. Assessment of Ventricular Function in Man.- 7. Stress Testing After Acute Myocardial Infarction.- 8. Coronary Angiography After Myocardial Infarction.- 9. Exercise Echocardiography After Myocardial Infarction.- III. Therapeutic Options.- 10. Beta Adrenoreceptor Blocking Drugs in Patients Who Have Suffered Acute Myocardial Infarction.- 11. Percutaneous Transluminal Coronary Angioplasty After Myocardial Infarction.- 12. Current Role of Surgery in Long Term Management of Patients After Myocardial Infarction.- 13. Psychological Aspects of the Treatment of Myocardial Infarction.- 14. Management of Risk Factors.- 15. Benefits of Exercise: Effect on Mortality and Physiological Function.- IV. Future Trends.- 16. Calcium Channel Blockers and Ischemia: A Review.- 17. Receptors in the Regulation of Lipoprotein Metabolism.- 18. Thromboxane and Prostacyclin in Platelet/Blood Vessel Interaction: A Commentary.
