急性心肌梗死AMI诊断和治疗进展（英文PPT课件） .ppt

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Calcium Antagonists GLUCOSE-INSULIN-POTASSIUM. Post MI Management Cardiac Stress Testing: Cardiac stress testing post-MI has established value in risk stratification and assessment of functional capacity Lipid Management: All post-MI patients should be on an American Heart Association Step II diet ( 200 mg cholesterol/day, 7% of total calories from saturated fats). Post-MI patients with LDL-cholesterol levels 100 mg/dL on a Step II diet are recommended to be on drug therapy to lower LDL-cholesterol levels 100 mg/dL. Post-MI patients with HDL-cholesterol levels 35 mg/dL on a Step II diet are recommended to participate in a regular exercise program and on drug therapy designed to increase HDL-cholesterol levels.4 Recent data indicate the all MI patients should be on statin therapy, regardless of lipid levels or diet Long-term Medications: Most oral medications instituted in the hospital at the time of MI will be continued long-term. Therapy with aspirin and beta-blockade is continued indefinitely in all patients. ACEI is continued indefinitely in patients with congestive heart failure, left ventricular dysfunction (ejection fraction 0.40), hypertension, or diabetes.4 A lipid-lowering agent, specifically a statin, in addition to dietary modification is continued indefinitely. Post MI Management(Cntd.) Implantable Cardiac Defibrillators: The results of the multi-center automatic defibrillator implantation trial II (MADIT II) have expanded the indications for automatic implantable cardiac defibrillators (AICD) in patients post-MI. The trial demonstrated a 31% relative risk reduction in all-cause mortality with the prophylactic use of an AICD in patients post-MI with ejection fractions less than 30%. Cardiac Rehabilitation: Arrhythmias in AMI MECHANISM OF ARRHYTHMIAS Arrhythmias occurring in patients with AMI require aggressiv