Via practica 11/2007

ACUTE MYOCARDIAL INFARCTION: ACTUAL MANAGMENT PRINCIPLES

Acute coronary syndromes represent leading cause of mortality in developed countries. Two categories of patients may be encountered: 1. myocardial infarction with persistent ST segments elevation (STEMI) and 2. acute coronary syndrome without ST segment elevation (NSTEACS). In STEMI total occlusion of coronary artery prevails and rapid reperfusion by primary angioplasty or fibrinolytic therapy is the main therapeutic objective. Successful and persistent reperfusion may influence myocardial infarction size and preserve left ventricular systolic function. In NSTE ASC patients are both complex pharmacological therapy and early risk stratification very important. Based on risk score result we can choose invasive strategy or conservative approach. Life style modification and consistent treatment of cardiovascular risk factors play key role in management of all ACS patients.

Keywords: acute coronary syndrome, myocardial infarction with ST segments elevation, acute coronary syndrome without ST segment elevation, unstable angina, fibrinolytic therapy, direct angioplasty.