The Pathophysiology and Pharmacotherapy of Myocardial Infarction

The Pathophysiology and Pharmacotherapy of Myocardial Infarction deals with the advances in the pathophysiology and pharmacotherapy of acute myocardial infarction and related complications. This book covers two major consequences-cardiac muscle dysfunction and cardiac electrical dysfunction. This text begins by reviewing the controversy surrounding the pathogenetic mechanisms of atheroma formation and its potential reversibility, including the status of coronary risk factors and benefits of primary prevention. The pathophysiologic mechanisms of pump failure and the current approach to its management are then deliberated, followed by a discussion on the rational use of vasodilators in post-infarction heart failure and pharmacotherapy of cardiogenic shock. The rationale for the interest in the role of coronary vasospasm and thrombolytic therapy for acute myocardial infarction is also covered. This publication concludes by reviewing the approaches for the management of post-infarction ventricular tachyarrhythmias and concept of secondary prevention of sudden cardiac death. This compilation is valuable to medical students, primary care physicians, and cardiovascular specialists.

ContributorsPreface1. Pathogenesis of Coronary Atherosclerosis: Prevention of Atherogenesis I. The Atherosclerotic Lesion II. Pathogenesis of Atherosclerosis III. Risk Factors in Atherogenesis IV. Clinical Trials V. Regression of Atheroma in Humans VI. Regression of Atheroma in Experimental Animals References2. Hemodynamic Consequences of Myocardial Infarction and the Role of Vasodilators in Acute and Chronic Management I. Introduction II. Hemodynamic Consequences of Heart Failure III. Potential Benefits of Vasodilators in Congestive Heart Failure IV. Classification and Mechanisms of Vasodilation V. Site of Action of the Vasodilators VI. Vasodilator Agents: Pharmacology, Hemodynamics, and Side Effects VII. Clinical Applications VIII. Summary References3. Pump Failure: Role of Vasopressor Agents I. Introduction II. Pathophysiology III. Role of Vasopressor Agents in the Treatment of Pump Failure IV. Future Directions References4. Coronary Artery Spasm and Pharmacology of Coronary Vasodilators I. Introduction II. Coronary Artery Spasm: Evolution of Current Concepts III. Coronary Artery Spasm and Myocardial Infarction IV. Pathophysiological Mechanisms V. Pharmacology of Coronary Vasodilators VI. Summary References5. Physiologic Basis and Results of Thrombolytic Therapy in Acute Myocardial Infarction I. Introduction II. Physiology of Thrombus Formation and Fibrinolytic Enzyme System III. Early Trials of Long-Duration, Late Intravenous Thrombolytic Therapy in Acute Myocardial Infarction IV. Intracoronary Streptokinase V. Intravenous Streptokinase VI. Management of Patients after Thrombolytic Therapy VII. Future Directions References6. Electrophysiology of Ventricular Arrhythmias in Myocardial Infarction I. Introduction II. Electrophysiological Mechanisms of Ventricular Arrhythmias III. Electrophysiological Mechanisms of Ventricular Arrhythmias in Myocardial Infarction IV. Conclusion References7. The Pharmacology of Antiarrhythmic Drugs I. Introduction II. Pharmacokinetics III. Antiarrhythmic Drugs IV. Summary References8. Mechanisms and Management of Myocardial Infarction Arrhythmias I. Introduction II. Mechanisms of Cardiac Arrhythmias III. Mechanisms of Arrhythmias during Infarction IV. Clinical Studies V. Pharmacology of Antiarrhythmic Drugs VI. Effects of Antiarrhythmic Drugs in Ischemie Tissue VII. Drug Therapy of Arrhythmias during Acute Myocardial Infarction VIII. Prophylaxis for Postinfarction Sudden Death IX. Conclusions References9. Pharmacologie and Surgical Therapy of Postinfarction Ventricular Arrhythmias I. Introduction II. Ventricular Ectopy and Nonsustained Ventricular Tachycardia III. Ventricular Fibrillation IV. Ventricular Tachycardia V. Summary References10. The Role of Beta Blockers in the Prevention of Sudden Cardiac Death in the Postinfarction Patient I. Introduction II. Methods III. Results IV. Discussion V. Summary ReferencesIndex