Management of the patient with myocardial infarction.

Coronary atherosclerotic heart disease and myocardial infarction constitute an epidemic in this century, mandating that the primary care physician be familiar with their recognition and management. However, in recent decades, an improved understanding of pathophysiologic alterations, an enormous advance in technology and significant accomplishments in pharmacology and operative procedures have virtually revolutionized the management of patients with myocardial infarction. Although patterns of care described in this monograph may well be obsolete a few years hence, to be superseded by safer, more precise, more efficient and more cost-effective therapeutic modalities, nevertheless basic principles underlying the management of the patient with myocardial infarction remain as appropriate guidelines. In the hospital phase, efforts should be directed toward enhancing survival, saving myocardium and restoring function. The long-term ambulatory care should be designed to maintain functional capacities, to control symptoms, to retard or arrest the atherosclerotic process thus decreasing the likelihood of recurrent myocardial infarction and/or of sudden cardiac death and to restore the patient to a normal or near-normal life style.