The role of coronary arteriography in the management of the patient with acute myocardial infarction.

Coronary arteriography is indicated in patients with acute myocardial infarction with complications such as ventricular septal rupture or papillary muscle rupture; when the ischemic pain recurs; or after acute myocardial infarction without major complications when information about the coronary anatomy is needed to establish prognosis and plan future therapy. Coronary arteriography after acute myocardial infarction is becoming more common as interventions such as coronary bypass surgery, streptokinase lysis of an acute thrombus, and transluminal angioplasty become more prevalent. Although arteriography has been reported to be safe, certain dangers exist and specific care must be taken to avoid them.