How to treat myocardial infarction?
summary
Myocardial infarction refers to the death of myocardial cells caused by prolonged ischemia, which is the result of the imbalance between supply and demand of myocardial perfusion. Myocardial ischemia can often be found through the patient's medical history, ECG and myocardial enzyme changes. Myocardial infarction sometimes presents as atypical symptoms, or even no symptoms, can only be detected by ECG, cardiac markers or imaging examination. The prognosis of patients with myocardial infarction is related to the size of infarct size, collateral circulation and timely treatment. How to treat myocardial infarction? Let's talk about it
How to treat myocardial infarction?
The patients without complications were absolutely bedridden for 1-3 days in the acute stage; Oxygen inhalation; Continuous ECG monitoring, heart rate, heart rhythm changes, blood pressure and respiration were observed. Pulmonary capillary wedge pressure and venous pressure were monitored when necessary in patients with hypotension and shock. Low salt, low fat, a small number of meals, keep bowel patency. After 3 days, the patients without complications gradually transferred to eating, urinating and indoor activities. Generally, they can be discharged within 2 weeks. Patients with heart failure, severe arrhythmia, hypotension, etc. should extend their bed rest time and discharge time as appropriate.
Reperfusion therapy is the most important treatment for acute ST segment elevation myocardial infarction. It can reduce the size of myocardial infarction and death by opening occluded coronary artery within 12 hours. The earlier the coronary artery is recanalized, the greater the benefit of patients“ Time is the heart, time is life. Therefore, all patients with acute ST segment elevation myocardial infarction must be diagnosed as soon as possible, and reperfusion treatment strategy should be made as soon as possible.
In hospitals with emergency PCI conditions, if the patients can complete the first balloon dilation within 90 minutes after arriving at the hospital, all patients with acute ST segment elevation myocardial infarction within 12 hours of onset should be treated with direct PCI. Balloon dilation can recanalize the coronary artery, and stents should be placed if necessary. Only infarct related arteries were treated in acute phase. Patients with cardiogenic shock should be treated with PCI regardless of the onset time. Therefore, patients with acute ST segment elevation myocardial infarction should go to the hospital with PCI conditions as far as possible.
matters needing attention
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