Related Experiment Videos
[Drug therapy of myocardial infarct in ambulatory practice]
Insights
Secondary prevention of myocardial infarction focuses on managing cardiac rhythm disturbances in the acute phase and after-treatment. Early intervention with appropriate medications is crucial for reducing lethality and improving patient outcomes.
Area of Science:
- Cardiology
- Pharmacology
Context:
- Myocardial infarction management presents challenges in secondary prevention, particularly in prehospital and after-treatment phases.
- Current practices emphasize managing cardiac rhythm disturbances over myocardial insufficiency in the acute outpatient setting.
Purpose:
- To outline medicamentous treatment strategies for myocardial infarction secondary prevention.
- To differentiate management approaches for uncomplicated versus complicated infarctions.
- To detail pharmacotherapy for bradycardic and tachycardic rhythm disturbances.
Summary:
- Acute phase management focuses on rhythm control, with glycosides, saluretics, and antiarrhythmics for complicated cases. Uncomplicated cases require sedation and heart volume reduction.
- After-treatment involves anticoagulants for uncomplicated cases. For active coronary heart disease post-infarction, a foundational therapy with glycosides and anticoagulants is recommended, supplemented by other agents as needed.
- The abstract also briefly touches upon volume substitution, acidosis treatment, and the use of beta-sympatholytics and glucocorticoids.
Impact:
- Provides a framework for physicians to optimize pharmacotherapy in myocardial infarction secondary prevention.
- Highlights the importance of tailored treatment based on infarction complexity and patient status.
- Aims to reduce mortality associated with cardiac rhythm disturbances in post-infarction patients.
Abstract:
For the practicing physician the medicamentous treatment of the patients with infarction is the main problem of the secondary prevention in the prehospital phase as well as in the after-treatment. In these cases in the acute phase not the myocardial insufficiency is in the centre of the out-patient care, but the therapy of the disturbances of cardiac rhythm, which mainly cause the high lethality in the early phase. Therefore, uncomplicated infarctions, in whch care must be taken only for a sedation of sympathico-adrenergic reactions and a volume reduction of the heart, should be differed from complicated cases. However, an immediate transport to the hospital must be guaranteed. If there appear a contraction insufficiency of the left ventricle or threatening disturbances of the rhythm, additionally glycosides and saluretics must be administered as well as an aimed antiarrhythmic therapy must be initiated. The necessary medicamentous measures are described dependent upon the diagnosis of brady- and tachycardiac disturbances of the rhythm. The author enters briefly the problems of volume substitution, treatment of acidosis as well as the administration of beta-sympathicolytics and gluco-corticoids. - In the after-treatment of infarctions anticoagulants are the only medicaments to be prescribed, when findings completely without complications are present. If, however, there are signs of activity of the coronary heart disease in the post-infarction phase, a basic therapy with a glycoside and anticoagulants as well as an individually to be varied additive therapy with nitro-preparations, beta-sympathicolytics, saluretics, anti-hypertensive agents and antiarrhythmic agents are necessary.