Treatment of Mycardial Infarction

Ischemia is the leading cause of death worldwide and myocardial infarction (MI) causes well over 12 million deaths per year internationally. However, with better detection and treatments, morbidity and mortality of this disease has been lessened.  This article provides a sweeping overview of treatment options.

Early treatment include clot bursting drugs and ballooning the arteries open. Medication used for treatment for angina pain includes nitrates, beta-blockers and calcium channel blockers. These drugs are either to increase or decrease the amount of blood that gets to the heart. Nitroglycerin, a type of nitrate is not only used for patients that has suffered a myocardial infarction within the first 24 hours, but also prescribed for certain cases of ischemic angina, uncontrolled hypertension and heart failure (Landmark & Reikvam 2003).

Coronary reperfusion therapy is done depending on the clinical condition of the patients. The three types are coronary thrombosis, percutaneous transluminal coronary angioplasty (PTCA) and coronary bypass surgery. Angioplasty is done to reduce or eliminate blockages in coronary arteries which ultimately restore normal blood flow to the heart tissue. A review was done to compare both thrombolytic reperfusion and angioplasty to indicate the best treatment for myocardial infarction (Nordmann et al 2005). Angioplasty fares better than thrombosis in decreasing the incidences of death, non-fatal MI and stroke but 50% of patients that underwent angioplasty experience restenosis (regrowth of plaque). Primary stenting is then done following angioplasty to keep the arteries remain open. The authors concluded that although primary stenting does not change mortality rate compared to those that only underwent angioplasty, reinfaction may be lessened.

REFERENCES

Patel H, Rosengren A, Ekman I (2004). Symptoms in acute coronary syndromes: does sex make a difference? Am Heart J.:148(1);27-33

Landmark K, Reikvam A. (2003). Nitrate therapy during and after acute myocardial infarction. Tidsskr Nor Laegeforen.:123(23);3377-80

Nordmann A, Bucher H, Hengstler P, Harr T, Young J. (2005). Primary stenting versus primary balloon angioplasty for treating acute myocardial infarction. Cochrane Database Syst Rev.