Active management of myocardial infarction

Intracoronary thrombolytic therapy performed within a coronary care unit: one year's experience

Acute myocardial infarction is associated with a high incidence of occluding coronary arterial thrombi. Thrombolytic therapy has been advocated to restore coronary artery blood flow and to reduce myocardial damage. Coronary arteriography and intracoronary thrombolytic therapy was administered to 61 patients admitted to a Coronary Care Unit within eight hours of symptoms. Successful reperfusion was obtained in 38 of 46 single vessel occlusions associated with a first coronary attack. Failure of reperfusion occurred in patients with two vessel occlusions or with cardiogenic shock. This study demonstrates the feasibility of applying this technique within a Coronary Care Unit with low capital and running costs, and suggests that its widespread application is possible even within the setting of a District General Hospital.

Hearts too good to die: an evaluation of coronary care

Intensive coronary care has become the standard treatment for acute myocardial infarction, and no self-respecting hospital would be without its coronary care unit. However, literature review to evaluate the contribution of coronary care shows that its promise may have been overstated and its benefits overestimated.

Angiogenesis factor from human myocardial infarcts

5 of 8 infarcted human myocardial tissues were shown to contain an angiogenesis factor which resembles that obtained from solid tumours. The concentration of angiogenesis factor, measured by radioimmunoassay, was similar to that in tumours. It is suggested that the myocardial-infarct angiogenesis factor modulates collateral enlargement or ingrowth of new blood vessels in the infarcted tissues.