Acute Myocardial Infarction : Emerging Concepts of Pathogenesis and Treatment

The presentation of new, emerging concepts of the pathogenesis and management of acute Myocardial Infarction is the unprecedented objective of this book. Based upon the Symposium on Acute MI, this timely text presents the advances that have taken place on several fronts in the past five years, particularly in the area related to thrombolytic therapy. Separated into four sections, the book covers the mechanisms of acute MI; medical problems of detection, sizing, and damage; non-invasive medical management; and invasive management. Of particular interest is the section on non-invasion management which focuses on the results from the TIMI Clinical Trial and the successful use of tissue plasminogen activator (tPA). Focus is also placed on the long-term follow up of patients treated with thrombolytic therapy and the no-reflow phenomenon in the stunned myocardium. A collaboration of recognized experts in their fields, this text is of extreme value to the practicing cardiologist, radiologist, surgeon and emergency care physician. The text's first section explores the basic mechanisms of coronary artery contraction, coronary artery stenosis and vasopasm. Its second section develops the pathophysiology of acute MI including the reversibility of ischemic myocardial injury, and methods for detecting the size and extent of myocardial infarcts. The crucial role of cardiac muscle cell membrane damage is also discussed. The physiology and pharmacology of tPA are described in the third section as are the results from the initial phase 1 TIMI trial. The final section which concentrates on surgical procedures, also provides future directions for the diagnosis and treatment of acute Myocardial Infarctions.