[Clinical periodization of myocardial infarct]

Comparison of the clinical and laboratory tests with the findings of post-mortem examination of 82 hearts of patients who had died in different periods after the onset of the disease allowed the authors to distinguish three periods in the clinical course of myocardial infarction: necrotic, inflammatory and adaptational. Fever, leukocytosis, the time course of MB CPK activity, and the results of polyelectrode ECG are reliable indicators of the duration of the necrotic period. The content of the protein-carbohydrate complexes in the blood adequately reflect the exudative-proliferative phase, while the content of collagen metabolites in blood and urine reflect the collagenization phase of the inflammatory period. These tests allow the physical activity of each patient to be individualized under objective control over the rate of healing of the myocardial infarct. Most patients become fully adapted to life with a reduced mass of contractile myocardium three months after the onset of the disease.