Quality of life after myocardial infarction

The long-term physical and psychologic well-being of patients who have sustained a myocardial infarction is dependent on skilled care during the first hours. Although the immediate preservation of life is the first priority, the relief of symptoms and anxiety and the protection of the myocardium are of short- and long-term importance not only to the quantity but also to the quality of life. Pain relief, particularly in the prehospital phase, is often inadequate. Fear, triggered by pain, may be aggravated by the environment; aggressive (and often unnecessary) measures and the inhuman use of technology may interfere with personal care. Intensive observation is essential for the control of dangerous arrhythmias; the early use of fibrinolytic agents and beta blockers limits the extent of myocardial damage and reduces mortality. The effectiveness of therapy for cardiac failure and shock is questionable. The value of invasive monitoring and of inotropic drugs is uncertain, although the relief of symptoms by diuretic agents and vasodilator drugs is not in doubt. Success in the management of myocardial infarction depends on a highly individualized approach.