[Myocardial infarction in the pre-hospital phase]

The pre-hospital phase of myocardial infarction has a major importance today, since it is unanimously recognized that the treatment should be started in the very few hours following the occurrence of the symptoms, in order to limit the size of the infarction and prevent complications, particularly rhythm disorders. The prevention of the ventricular rhythm disorders justifies the use of lidocain. A review of the literature is carried out in order to evaluate the results obtained with this product, used intravenously or intramuscularly, before the arrival of the patient in the hospital. The attempt to limit the size of the necrotic area leads to consider the efficacy of calcium antagonists, beta blockers and mainly fibrinolytic agents or tissue activators of plasminogen, used during the first 4 to 6 hours, at home or in the specialized ambulance taking the patient to the hospital. A review of the first results is presented.