TY  - CHAP
M1  - Book, Section
TI  - Myocardial Revascularization after Acute Myocardial Infarction
A1  - Smith III, Deane E.
A1  - R. Williams, Mathew
A2  - Cohn, Lawrence H.
A2  - Adams, David H.
PY  - 2017
T2  - Cardiac Surgery in the Adult, 5e
AB  - Acute  myocardial  infarction  (MI)  affects  approximately  1.5  million  individuals  each  year  in  the  United  States.1  Of  these  patients,  30%  die  before  reaching  the  hospital  and  another  5%  die  during  their  hospital  admission.1  Since  1998,  the  death  rate  from  cardiovascular  disease  has  declined  30.6%;  however,  cardiovascular  disease  remains  the  leading  cause  of  death  in  the  United  States.2  Prompt  medical  attention  including  transport  to  the  hospital,  diagnosis,  and  treatment  of  the  MI  is  critical  to  patient  survival.  Over  the  past  40  years,  many  developments  have  led  to  a  decrease  in  the  overall  morbidity  and  mortality  associated  with  acute  MI.  These  developments  include  new  pharmacologic  agents,  advancement  in  interventional  cardiology  procedures,  modifications  of  coronary  artery  bypass  surgical  techniques,  and  the  development  of  treatment  algorithms  and  guidelines.  Despite  these  advances,  mechanical  and  electrical  complications  such  as  cardiogenic  shock,  rupture  of  the  ventricular  septum  or  free  wall,  acute  mitral  regurgitation,  pericarditis,  tamponade,  and  arrhythmias  continue  to  challenge  the  medical  community  caring  for  patients  presenting  with  acute  MI  on  a  daily  basis.3  Of  these  complications,  cardiogenic  shock  complicating  acute  MIs  has  the  most  significant  impact  on  in-hospital  mortality  and  long-term  survival.  The  loss  of  more  than  40%  of  functioning  left  ventricular  mass  and  its  accompanying  systemic  inflammatory  response  are  the  major  causes  of  cardiogenic  shock.  Factors  that  impact  the  development  of  cardiogenic  shock  include  the  degree  of  pre-infarct  ventricular  dysfunction,  the  size  of  the  infarcted  vessel,  and  pathologic  level  of  inflammatory  mediators.4,5  Revascularization  of  threatened  myocardium  offers  the  best  chance  of  survival  following  acute  coronary  occlusion,  but  the  technique  and  timing  of  revascularization  continue  to  evolve.  The  available  therapies  that  can  decrease  the  mortality  associated  with  acute  MIs  include  thrombolytics,  percutaneous  coronary  intervention  (PCI),  and  coronary  artery  bypass  graft  (CABG)  surgery.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/17
UR  - accesscardiology.mhmedical.com/content.aspx?aid=1144152364
ER  -