Interventional therapy for the treatment of acute myocardial infarction: thrombolysis with and without angioplasty. A brief review of the literature and the experience at a community hospital.
Thrombolytic therapy is a feasible, practical, and important approach to the treatment of the patient with an acute myocardial infarction. Data have conclusively demonstrated improvement in both postinfarction indices of left ventricular function and overall survival statistics. Definitive treatment for the underlying coronary lesion may be done acutely with percutaneous transluminal coronary angioplasty or the patient may undergo elective bypass surgery or coronary angioplasty at a later time, depending on the clinical circumstances. Direct intracoronary infusion of the thrombolytic agent is the most effective route of administration. However, if it is not possible for the patient to be taken to a cardiac catheterization laboratory, the intravenous route may be used. Further development of newer thrombolytic agents will undoubtedly make this mode of therapy standard and routine for the patient with acute myocardial infarction.
D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon; D006328:Cardiac Catheterization; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003326:Coronary Circulation / Q000187:drug effects; D003327:Coronary Disease / Q000150:complications / Q000473:pathology; D004632:Emergency Medical Services; D005069:Evaluation Studies as Topic; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects; D005343:Fibrinolytic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007267:Injections / Q000379:methods; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery; D013300:Streptokinase / Q000008:administration & dosage / Q000627:therapeutic use; D010959:Tissue Plasminogen Activator / Q000494:pharmacology / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D013300:Streptokinase; D010959:Tissue Plasminogen Activator