[After care of acute myocardial infarct: what are the 4 most important points?].
The variable prognosis after myocardial infarction necessitates an individual tailoring of follow-up treatment. Therapeutic decisions must be based on a complete risk stratification including assessment of persisting ischemia, left ventricular function, rhythmic instability and cardiovascular risk factor profile. High risk patients (prognostic indication) as well as symptomatic patients (symptomatic indication) should be referred for coronary angiography to assess the need for revascularisation procedures (PTCA, CABG). The individual risk profile also defines drug therapy for secondary prevention (not more than 3-4 drugs): anti-platelet agents or anticoagulation in every patient; beta blockers in all but the lowest risk group; ACE-inhibitors in heart failure or asymptomatic, substantial left ventricular dysfunction; liberal use of cholesterol-reducing drugs. Life style alterations should be encouraged in almost every patient. Information about the necessary measures to be taken upon occurrence of angina at rest or other cardiac symptoms must be repeatedly given to all patients.
Kurz
D J
DJ
Kardiologie, Medizinische Klinik, Stadtspital Triemli, Zürich.
Bertel
O
O
D000359:Aftercare / Q000379:methods*; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D006801:Humans; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000534:rehabilitation*; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors