DIAGNOSIS AND TREATMENT OF MYOCARDIAL INFARCTION
TABLE OF CONTENTS
(translated from Ukrainian)
|
Preface |
6 |
|
Historic vignette |
8 |
|
Chapter I. Epidemiology of Acute Myocardial Infarction |
10 |
|
Some statistical data |
10 |
|
Cardiovascular mortality as the main contributing factor in population decline in the former Soviet Union |
12 |
|
Psychosocial stress, depression as risk factors for coronary artery disease |
13 |
|
Chapter II. Pathogenesis of acute myocardial infarction |
16 |
|
Three major mechanisms in the pathogenesis of acute myocardial infarction |
16 |
|
Unstable atherosclerotic plaque |
19 |
|
Can unstable plaque be identified in advance? |
21 |
|
When and how does the intracoronary thrombus form after plaque rupture? |
23 |
|
Fatal vasospasm or the Love of cocaine ending |
25 |
|
When does acute myocardial infarction occur most often? |
26 |
|
Chapter III. Clinical and laboratory diagnosis of acute myocardial infarction |
28 |
|
Signs and symptoms of acute myocardial infarction |
28 |
|
Differential diagnosis of chest pain syndromes |
32 |
|
History and physical examination |
35 |
|
Laboratory findings |
36 |
|
Complete blood count |
36 |
|
Serum markers of myocardial damage |
37 |
|
Chapter IV. EKG diagnosis of Q wave myocardial infarction |
31 |
|
General considerations |
31 |
|
Pardee wave as a mirror of coronary occlusion |
32 |
|
Significant Q wave |
33 |
|
What should we now call transmural infarction? |
36 |
|
EKG evolution in Q wave myocardial infarction |
37 |
|
Topical EKG diagnosis in acute myocardial infarction |
38 |
|
EKG diagnosis of evolving acute myocardial infarction in the presence of left bundle-branch block |
50 |
|
The role of electrocardiotopography and additional EKG leads in diagnosis of acute myocardial infarction |
53 |
|
Pseudoinfarction EKG patterns |
55 |
|
Electrocardio-angiographic parallels in acute myocardial infarction |
57 |
|
Coronary artery anatomy |
58 |
|
Left coronary artery |
59 |
|
Right coronary artery (RCA) |
62 |
|
Three types of coronary circulation: balanced, left- and right-dominant |
63 |
|
Proximal left anterior descending artery total occlusion myocardial infarction |
68 |
|
Proximal left circumflex artery total occlusion myocardial infarction |
72 |
|
Proximal RCA total occlusion myocardial infarction |
73 |
|
Chapter V. The role of echocardiography in acute myocardial infarction |
75 |
|
General considerations |
75 |
|
Echocardiography in patients with right ventricular infarction |
83 |
|
Practical tips |
85 |
|
Chapter VI. Essentials of cardiopulmonary resuscitation (CPR) |
88 |
|
Being prepared to provide basic life support |
88 |
|
Proper CPR technique |
90 |
|
One-rescuer cardiopulmonary resuscitation |
93 |
|
Two-rescuer cardiopulmonary resuscitation |
93 |
|
The science of defibrillation |
95 |
|
Automatic external defibrillator treatment algorithm |
97 |
|
How to predict clinical outcome after resuscitation from cardiac arrest? |
98 |
|
Chapter VII. Major treatment principles |
99 |
|
Prehospital treatment |
99 |
|
Coronary care unit |
101 |
|
Intermediate coronary care unit |
105 |
|
Hospital management |
106 |
|
The first 23 hours |
106 |
|
After the first 23 hours |
109 |
|
Preparation for discharge from the hospital |
112 |
|
Discharge patient recommendations |
112 |
|
Guidelines for diet therapy in the coronary care unit |
113 |
|
Physical activity progression following myocardial infarction |
113 |
|
Convalescent risk assessment strategies |
117 |
|
Psychological aspects in the treatment of myocardial infarction patients |
118 |
|
Chapter VIII. Pharmacologic management of acute myocardial infarction: Incorporating results of clinical trials into everyday practice |
121 |
|
Analgesics |
121 |
|
Aspirin and other antiplatelet agents |
123 |
|
Nitrates |
127 |
|
Beta-blockers |
130 |
|
In acute phase of myocardial infarction |
130 |
|
Practical implications |
133 |
|
In secondary prevention of coronary artery disease |
138 |
|
Practical recommendations |
133 |
|
ACE inhibitors |
150 |
|
Heparin |
157 |
|
Glucose-insulin-potassium |
161 |
|
Glucose-insulin in diabetics with acute myocardial infarction |
165 |
|
Magnesium |
168 |
|
Lipid lowering therapy |
169 |
|
On Mediterranean diet |
173 |
|
Drug interactions: focusing on the coronary care unit medications |
175 |
|
Chapter IX. Thrombolysis in acute myocardial infarction |
177 |
|
Reperfusion strategies in acute myocardial infarction |
177 |
|
Theoretical background for reperfusion therapy in acute myocardial infarction |
178 |
|
Beginning of the thrombolytic era |
180 |
|
Wide use of intravenous thrombolysis |
181 |
|
Thrombolysis reduces mortality in acute myocardial infarction: The GISSI study |
183 |
|
Subgroup analysis of the efficacy of thrombolysis |
185 |
|
Dark side of thrombolysis |
186 |
|
Other randomized studies of thrombolysis efficacy in mortality reduction |
187 |
|
How long does it take to lyse the intracoronary thrombus? (The TIMI-1 study) |
188 |
|
Showdown between streptokinase and alteplase: The GUSTO study |
191 |
|
What does early thrombolysis really mean or one hundred minutes after the onset of acute myocardial infarction |
195 |
|
Tailoring thrombolytic therapy to a patient with acute myocardial infarction |
198 |
|
Searching for third generation fibrinolytics and best thrombolytic cocktail |
199 |
|
Reteplase |
201 |
|
Lanoteplase |
202 |
|
Tenecteplase |
202 |
|
Pharmacologic properties of fibrinolytics |
203 |
|
Indications for thrombolysis in acute myocardial infarction |
205 |
|
Fibrinolytic regimens for acute myocardial infarction |
207 |
|
Contraindications for thrombolysis in acute myocardial infarction |
208 |
|
How to predict individual risk of intracranial hemorrhage complicating thrombolytic therapy in acute myocardial infarction? |
209 |
|
Chapter X. Primary angioplasty, stents in acute myocardial infarction |
211 |
|
General considerations |
211 |
|
Primary angioplasty vs. thrombolysis: Results of randomized trials |
212 |
|
Case report |
218 |
|
Primary angioplasty in patients with cardiogenic shock complicating acute myocardial infarction |
222 |
|
A real-life experience with primary angioplasty |
227 |
|
Practical recommendations |
230 |
|
Role of IIb/IIIa inhibitors |
233 |
|
Stents after primary angioplasty |
236 |
|
Facade and the dark side of stenting |
236 |
|
Case report |
238 |
|
Subacute stent thrombosis and how to fight it |
232 |
|
The role of IIb/IIIa-inhibitors in stenting |
233 |
|
Stent restenosis |
238 |
|
Practical recommendations |
239 |
|
Chapter XI. Secondary angioplasty in acute myocardial infarction |
251 |
|
Early secondary angioplasty |
251 |
|
Immediately after successful thrombolysis |
251 |
|
Hours to days after successful thrombolysis |
253 |
|
Urgent secondary (rescue) angioplasty after unsuccessful thrombolysis |
255 |
|
Case report |
259 |
|
PACT about peaceful coexistence between thrombolytics and angioplasty |
267 |
|
Full scale reperfusion program: thrombolytic cocktail +/-angioplasty |
269 |
|
What is wrong with fibrinolytics? |
270 |
|
Fibrinolytic (full dose) + IIb/IIIa-antagonist |
272 |
|
Fibrinolytic (low dose) + IIb/IIIa-antagonist |
273 |
|
Low molecular weight heparins, hirudin |
275 |
|
Late secondary angioplasty |
277 |
|
Is routine predischarge angiography/angioplasty justified? |
277 |
|
Undocking between theory and clinical practice |
281 |
|
Chapter XII. Recognition and treatment of acute myocardial infarction complications |
283 |
|
Acute heart failure |
283 |
|
Cardiogenic shock |
287 |
|
Diagnosis of cardiogenic shock |
290 |
|
Treatment of cardiogenic shock |
292 |
|
Bradycardia treatment algorithm |
296 |
|
Asystole treatment algorithm |
298 |
|
Ventricular fibrillation/pulseless ventricular tachycardia treatment algorithm |
300 |
|
Atrial fibrillation |
301 |
|
SVT treatment algorithm |
302 |
|
Ventricular tachycardia |
303 |
|
Implantable defibrillators |
309 |
|
Cosmetic aneurysmectomy as a treatment option in patients with late postinfarction ventricular tachycardia |
312 |
|
Right ventricular infarction |
318 |
|
Cardiac rupture, pseudoaneurysm |
320 |
|
Chapter XIII. Ticket #13 or self-assessment questions |
326 |
|
Answers |
332 |
|
Appendix I. Role of intra-aortic balloon pumping in treatment of acute myocardial infarction complicated by cardiogenic shock |
333 |
|
Practical tips in IABP |
330 |
|
Appendix II. Patient education materials |
335 |
|
How can one effectively put himself on the verge of developing heart attack? |
335 |
|
Everybody has to know this: Heart attack warning signs |
336 |
|
Understanding angina and the role of nitroglycerine |
337 |
|
Valerian or an herb that helps to control stress |
352 |
|
Drops' prescriptions by Drs. Strazhesko, Votchal, Zelenin |
354 |
|
Ode to oat bran or an easy way to reduce your cholesterol level |
356 |
|
How to quit smoking (Another prescription) |
358 |
|
Bibliography |
362 |
|
List of recommended slides |
406 |