Why do patients die after myocardial infarction?
Death during and following myocardial infarction can arise from a number of different causes. Some of them, such as early ventricular fibrillation and cardiac rupture, seem unrelated to infarct size. However, deaths occurring later during the course of infarction do seem to be related to the extent of myocardial damage and to such phenomena as infarct extension and expansion, and the mechanisms involved include cardiac failure and shock, and late arrhythmias. Preventive measures must be directed at the various mechanisms involved. Thrombolytic drugs, by limiting infarct size, prevent death from several causes, whereas beta-blockers seem mainly to operate by preventing early rupture, reinfarction, and late ventricular fibrillation. Aspirin prevents reinfarction. Angiotensin-converting enzyme (ACE) inhibitors may prove to have a beneficial role in the early phase by unloading the heart and later by preventing infarct expansion and subsequent cardiac failure.
Julian
D G
DG
British Heart Foundation, London, England.
D002423:Cause of Death; D006801:Humans; D009203:Myocardial Infarction / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology*