Early Interventions in Acute Myocardial Infarction

270 Pages·1989·7.74 MB·English

by  Nora Goldschlager

EARL Y INTERVENTIONS IN ACUTE MYOCARDIAL INFARCTION
DEVELOPMENTS IN CARDIOVA SCULAR MEDICINE
Morganroth, J., Moore, E. N., eds.: Interventions in the acute phase of myocardial infarction.
ISBN 0-89838-659-4.
Abel, F.L., Newman, W.H., eds.: Functional aspects of the normal, hypertrophied, and failing
heart. ISBN 0-89838-665-9.
Sideman, S., and Beyar, R., eds.: Simulation and imaging of the cardiac system. ISBN
0-89838-687-X.
van de Wall, E., Lie, K.I., eds.: Recent views on hypertrophic cardiomyopathy. ISBN
0-89838-694-2.
Beamish, R.E., Singal, P. K., Dhalla, N. S., eds.: Stress and heart disease. ISBN 089838-709-4.
Beamish, R.E., Panagia, V., Dhalla, N. S., eds.: Pathogenesis of stress-induced heart disease.
ISBN 0-89838-710-8.
Morganroth, J., Moore, E.N., eds., Cardiac arrhythmias: New therapeutic drugs and devices.
ISBN 0-89838-716-7.
Mathes, P., ed.: Secondary prevention in coronary artery disease and myocardial infarction.
ISBN 0-89838-736-1.
Stone, H. Lowell, Weglicki, W. B., eds.: Pathology of cardiovascular injury. ISBN
0-89838-743-4.
Meyer,]., Erbel, R., Rupprecht, H.]., eds.: Improvement of myocardial perfusion. ISBN
0-89838-748-5.
Reiber,]. H. c., Serruys, P. W., Slager, c.].: Quantitative coronary and left ventricular
cineangiography. ISBN 0-89838-760-4.
Fagard, R.H., Bekaert, I.E., eds.: Sports cardiology. ISBN 0-89838-782-5.
Reiber, ].H.C., Serruys, P. W., eds.: State of the art in quantitative coronary arteriography. ISBN
0-89838-804-X.
Roelandt, J., ed.: Color doppler flow imaging. ISBN 0-89838-806-6.
van de Wall, E. E., ed.: Nonmvasive imaging of cardiac metabolism. ISBN 0-89838-812-0.
Liebman,]., Plonsey, R., Rudy, Y., eds.: Pediatric and fundamental electrocardiography. ISBN
0-89838-815-5.
Higler, H., Hombach, V., eds.: Invasive cardiovascular therapy. ISBN 0-89838-818-X.
Serruys, P. W., Meester, G. T., eds.: Coronary angioplasty: a controlled model for ischemia. ISBN
0-89838-819-8.
Tooke,]. E., Smaje, L. H., eds.: Clinical investigation of the microcirculation. ISBN
0-89838-833-3.
van Dam, Th., van Oosterom, A., eds.: Electrocardiographic body surface mapping. ISBN
0-89838-834-1.
Spencer, M. P., cd.: Ultrasonic diagnosis of cerebrovascular disease. ISBN 0-89838-836-8.
Legato, M.J., ed.: The stressed heart. ISBN 0-89838-848-X.
Safar, M.E., cd.: Arterial and venous systems in essential hypertension. ISBN 0-89838-857-0.
Roelandt,]., ed.: Digital techniques in echocardiography. ISBN 0-89838-861-9.
Dhalla, N.S., Singal, P.K., Beamish, R.E., cds.: Pathophysiology of heart disease. ISBN
0-89838-864-3.
Dhalla, N.S., Pierce, G.N., Beamish, R.E., cds.: Heart function and metabolism. ISBN
0-89838-865-1.
Dhalla, N.S., Innes, I.R., Beamish, R.E., eds.: Myocardial ischemia. ISBN 0-89838-866-X.
Beamish, R. E., Panagia, V., Dhalla, N. S., eds.: Pharmacological aspects of heart disease. ISBN
0-89838-867-8.
Ter Keurs, H.E.D.]., Tyberg,]. V., eds.: Mechanics of the circulation. ISBN 0-89838-870-8.
Sideman, S., Beyar, R., eds.: Activation metabolism and perfusion of the heart. ISBN
0-89838-871-6.
Aliot, E., Lazzara, R., eds.: Ventricular tachycardias. ISBN 0-89838-881-3.
Schneeweiss, A., Schettler, G.: Cardiovascular drug therapy in the elderly. ISBN 0-89838-883-X.
Chapman, J. V., Sgalambro, A., eds.: Basic concepts in doppler echocardiography. ISBN
0-89838-888-0.
Chien, S., Dormandy,]., Ernst, E., Matrai, A., eds.: Clinical hemorheology. ISBN
0-89838-807-4.
Morganroth, J., Moore, E. Neil, eds.: Congestive heart failure. ISBN 0-89838-955-0.
I:-leintzen, P .H., Bursch, J. H., eds.: Progress in digital angiocardiography. ISBN 0-89838-965-8.
Scheinman, M., ed.: Catheter ablation of cardiac arrhythmias. ISBN 0-89838-967-4.
Spaan, ].A.E., Bruschke, A. V. G., Gittenberger, A. c., eds.: Coronary circulation. ISBN
0-89838-978-X.
Bayes de Luna, A., ed.: Therapuetics in cardiology. ISBN 0-89838-981-X.
Kappagoda, C. T., Greenwood, P. V., eds.: Long-term management of patients after myocardial
infarction. ISBN 0-89838-352-8.
EARL Y INTERVENTIONS IN ACUTE
MYOCARDIAL INFARCTION
edited by
ELLIOT RAPAPORT, M.D.
School of Medicine
University of California, San Francisco
"~.
KLUWER ACADEMIC PUBLISHERS
BOSTON/DORDRECHT/LONDON
Copyright © 1989 by Kluwer Academic Publishers.
Softcover reprint of the hardcover 1s t edition 1989
All rights reserved. No part of this publication may be reproduced, stored in a
retrieval system or transmitted in any form or by any means, mechanical,
photocopying, recording, or otherwise, without the prior written permission
of the publisher, Kluwer Academic Publishers, 101 Philip Drive, Assinippi
Park, Norwell, Massachusetts 02061.
Distributors for North America:
Kluwer Academic Publishers
101 Philip Drive
Assinippi Park
Norwell, Massachusetts 02061 USA
Distributors for all other countries:
Kluwer Academic Publishers Group
Distribution Centre
Post Office Box 322
3300 AH Dordrecht, THE NETHERLANDS
Library of Congress Cataloging-in-Publication Data
Early interventions in acute myocardial infarction/edited by Elliot Rapaport.
p. cm. - (Developments in cardiovascular medicine; 97)
Includes index.
ISBN-13: 978-1-4612-8884-8 e-ISBN-13: 978-1-4613-1597-1
DOl: 10.1007/978-1-4613-1597-1
1. Heart-Infarction-Treatment. 2. Heart-Infarction-
-Pathophysiology. I. Rapaport, Elliot, 1924- II. Series:
Developments in cardiovascular medicine; v. 97.
[DNLM: 1. Myocardial Infarction-therapy. WI DE997VME v. 97/WG
300E117]
RC685.16E28 1989
616.1 '23706---dc19
DNLM/DLC
for Library of Congress 89-2329
ClP
CONTENTS
Contributing Authors Vll
Preface Xl
1. Management of Arrhythmias in the Coronary Care Unit
NORA GOLDSCHLAGER, RODERICK WOODS, AND NEAL BENOWITZ
2. Thrombolysis in the Management of Acute Myocardial Infarction 45
H.J.C. SWAN
3. The Role of Free Radicals in the Pathogenesis of Posti schemic Reperfusion
Injury 67
JAY L. ZWEIER AND JOHN T. FLAHERTY
4. Percutaneous Transluminal Coronary Angioplasty in Acute Myocardial
Infarction 75
MICHEL E. BERTRAND, JEAN M. LABLANCHE, JEAN L. FOURRIER, AND A. GOMMEAUX
5. The Role of Emergency Bypass Surgery in Acute Myocardial Infarction 85
NICHOLAS T. KOUCHOUKOS AND WILLIAM G. MARSHALL, JR.
6. The Role of Nitroglycerin in Acute Myocardial Infarction 95
JOHN T. FLAHERTY
7. The Role of Calcium Antagonists in Acute Myocardial Infarction 123
BRAMAH N. SINGH AND WINIFRED NAYLER
8. Postinfarction Angina 143
ELLIOT RAPAPORT
v
vi Contents
9. The Management of Pump Failure 155
KANU CHATTERJEE
to. The Role of Nuclear Cardiology in the Assessment of Myocardial Infarction and
the Evaluation of Early Interventions 187
DAVID S. KAYDEN, FRANS J. TH. WACKERS, AND BARRY L. ZARET
11. Risk Stratification After Acute Myocardial Infarction: Theory and Practice 213
ELIZABETH A. GILPIN AND JOHN ROSS, JR.
Index 259
CONTRIBUTING AUTHORS
Neal L. Benowitz, M.D.
Professor of Medicine
Chief, Division of Clinical Pharmacology
and Experimental Therapeutics
San Francisco General Hospital
University of California, San Francisco
School of Medicine
San Francisco, California 94110, U.S.A.
M.E. Bertrand, M.D., F.A.C.C.
Professor of Medicine
Chief, Division of Cardiology
University ofLiIle
59037 LiIle, Cedex, France
Ranu Chatterjee, M.B., F.R.C.P.
Professor of Medicine
Lucie Stern Professor of Cardiology
University of California, San Francisco
School of Medicine
San Francisco, California 94143, U.S.A.
John T. Flaherty, M.D.
Associate Professor of Medicine
The Division of Cardiology
Department of Medicine
Johns Hopkins University
School of Medicine
Baltimore, Maryland 21205, U.S.A.
vii
viii Contributing authors
Jean L. Fourrier, M.D.
Senior Resident
Division of Cardiology
University ofLille
59037 Lille, Cede x, France
Elizabeth Gilpin, M.S.
University of California, San Diego
Department of Medicine/Division of
Cardiology
San Diego, California 92103, U.S.A.
Nora Goldschlager, M.D., F.A.C.C.
Professor of Clinical Medicine
University of California, San Francisco,
School of Medicine
Director, Coronary Care Unit
San Francisco General Hospital
San Francisco, California 94110, U.S.A.
Antoine Gommeaux, M.D.
Senior Resident
Division of Cardiology
University ofLille
59037 Lille, Cedex, France
David S. Kayden, M.D.
Instructor in Internal Medicine
and Diagnostic Radiology
Section of Cardiology and Nuclear Medicine
Yale University School of Medicine
New Haven, Connecticut 06510, U.S.A.
Nicholas T. Kouchoukos, M.D.
John M. Shoen berg Professor of
Cardiovascular Surgery
Washington University School of Medicine;
Cardiovascular and Thoracic Surgeon-in-Chief
The Jewish Hospital of St. Louis
St. Louis, Missouri 63110, U.S.A.
Jean M. Lablanche, M.D.
Professor of Medicine
University ofLille
59037 Lille, Cedex, France
William G. Marshall,Jr., M.D.
Staff Thoracic and Cardiovascular Surgeon
The Watson Clinic
Lakeland, F1orid·a 33802, U. S. A.
Winifred Nayler, D.Sc.
Department of Medicine
University of Melbourne
Austin Hospital
Heidelberg! Victoria, Australia
ix
Elliot Rapaport, M.D.
Professor of Medicine
William Watt Kerr Professor of Medicine
University of California, San Francisco,
School of Medicine
Chief, Cardiology Division
San Francisco General Hospital
San Francisco, California 94110, U.S.A.
John Ross,Jr., M.D.
Professor of Medicine
Head, Division of Cardiology
Department of Medicine
University of California, San Diego
San Diego, California 92103, U.S.A.
BramahN. Singh, M.D., D. Phil., F.R.C.P.
Wadsworth Veterans Administration Hospital
and Department of Medicine
University of California, Los Angeles,
School of Medicine
Los Angeles, California 90073, U.S.A.
H.J.C. Swan, M.D., Ph.D., M.A.C.P.
Professor of Medicine
University of California, Los Angeles,
School of Medicine
Senior Cardiology Consultant
Cedars-Sinai Medical Center
Los Angeles, California 90024, U.S.A.
FransJ. Th. Wackers, M.D.
Professor of Diagnostic Radiology and
Medicine
Director of Cardiovascular Nuclear Imaging
and Exercise Laboratories
Yale U ni versity School of Medicine
New Haven, Connecticut 06510, U.S.A.
Roderick Woods, M.D.
Major, M.e. and Staff Cardiologist,
Walter Reed Army Medical Center
Washington, D.e. 20012, U.S.A.
Barry L. Zaret, M.D.
Robert W. Berliner Professor of Medicine
Professor of Diagnostic Radiology
Chief, Section of Cardiology
Yale University School of Medicine
New Haven, Connecticut 06510, U.S.A.
Jay L. Zweier, M.D.
Assistant Professor of Medicine
Division of Cardiology
Department of Medicine
Johns Hopkins University
School of Medicine
Baltimore, Maryland 21205, U.S.A.
PREFACE
Our understanding of the pathophysiology of acute myocardial infarction has
grown enormously in recent years. This has led to an increasingly aggressive
approach to management, designed to blunt the extent of infarction by
salvaging acutely ischemic myocardium. Alternatives now include throm
bolysis, PTCA with and without prior thrombolysis, and emergency bypass
surgery, as well as the more aggressive use of a variety of drugs. This book
consists of a series of chapters by experienced cardiologists and cardiovascular
surgeons that present today's state of the art in managing acute myocardial
infarction. It is written with the purpose of presenting practical approaches of
value to the clinician related to the more complex problems faced in dealing
with patients undergoing myocardial infarction.
xi