Surgical treatment of complications of acute myocardial infarction

Article Abstract:

Myocardial ischemia is the inadequate supply of blood to the heart, which may lead to infarction, the deterioration of heart tissue due to cessation of blood supply. Patients who suffer acute or sudden myocardial infarction (MI, heart attack) followed by a poor prognosis and poor surgical outcome, develop complications within the first two weeks after onset of the heart attack. The most frequent complications of acute MI are persistent ischemia, severe impairment of left ventricle function, and cardiogenic shock, or inadequate circulation to the tissues due to impaired heart function. Monitoring circulation and treatments that improve the oxygen supply and demand of the heart alter the prognosis of an MI. Reperfusion or renewal of the blood supply to the ischemic region has resulted in the greatest improvement of complications. The objective of surgical treatment of MI is to restore effective heart function during the systolic or contraction phase of the heart cycle and, consequently, provide satisfactory blood flow to the tissues of the body. Surgery is used to treat mechanical complications, such as rupture or dilation of the left ventricle, and nonmechanical complications, such as obstruction of the coronary arteries supplying the heart. Persistent impairment of left ventricle function and cardiogenic shock are the most important factors that negatively influence a patient's recovery from acute myocardial infarction. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surgery, Coronary heart disease, Heart, Infarction, Heart surgery

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Early revascularization in cardiogenic shock -- a positive view of a negative trial

Article Abstract:

Emergency revascularization using angioplasty or coronary bypass surgery may be helpful to patients in cardiogenic shock. Cardiogenic shock occurs when blood pressure drops and body organs do not receive enough blood. It sometimes occurs after a heart attack. A 1999 study of cardiogenic shock found that the 30-day mortality rate in the group that received emergency revascularization was 17% lower than in the group that received standard care. Although this reduction is small, it represents 93 lives saved for every 1,000 patients treated. This is twice the number saved by giving heart attack patients drugs to break up blood clots.

Editorial, Evaluation, Myocardial revascularization

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Should survivors of myocardial infarction with low ejection fraction be routinely referred to arrhythmia specialists?

Article Abstract:

It is probably not necessary to screen every person who has a heart attack to determine whether they need anti-arrhythmia medication. These patients have a high risk of arrhythmias that can cause sudden death, especially after hospital discharge. Researchers used a modelling process to determine how screening would affect mortality rates from sudden death. Although anti-arrhythmia drugs and implantable defibrillators reduce the risk of sudden death, they do not reduce overall mortality rates substantially.

Models, Prevention, Medical screening, Health screening, Sudden death

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