心筋梗塞の最新の治療について : 発症の現場から急性期治療まで

概要

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Acute myocardial infarction（AMI）refers to a condition in which an intracoronary thrombusrapidly develops at the onset of rupture of vulnerable coronary plaques, affecting blood flow and leadingto myocardial necrosis. Therefore, the concept of AMI treatment is to achieve coronary reperfusionearlier. Currently, in Japan, percutaneous coronary intervention（PCI）is primarily employedfor reperfusion treatment due to its promptness and accuracy. Acute treatment with a catheter hasadvanced : from conventional balloon angioplasty to the development of devices／procedures forcoronary stent implantation, topical thrombus aspiration, and peripheral protection. It is also importantto manage acute complications. In accordance with the circumstances, DC shock, transient pacemakerinsertion, intra-aortic balloon pumping（IABP）, and the application of percutaneous cardiopulmonarysupport（PCPS）must be promptly performed. To protect the injured myocardium andcontrol other vulnerable plaques, early drug intervention is also very important. Prompt, appropriatecardiopulmonary resuscitation before arrival and prompt transport to a hospital in which specializedtreatment is possible are important for initial management rather than in-hospital treatment.
2011-08-25