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

Acute myocardial infarction（AMI）refers to a condition in which an intracoronary thrombus rapidly develops at the onset of rupture of vulnerable coronary plaques, affecting blood flow and leading to myocardial necrosis. Therefore, the concept of AMI treatment is to achieve coronary reperfusion earlier. Currently, in Japan, percutaneous coronary intervention（PCI）is primarily employed for reperfusion treatment due to its promptness and accuracy. Acute treatment with a catheter has advanced : from conventional balloon angioplasty to the development of devices／procedures for coronary stent implantation, topical thrombus aspiration, and peripheral protection. It is also important to manage acute complications. In accordance with the circumstances, DC shock, transient pacemaker insertion, intra-aortic balloon pumping（IABP）, and the application of percutaneous cardiopulmonary support（PCPS）must be promptly performed. To protect the injured myocardium and control other vulnerable plaques, early drug intervention is also very important. Prompt, appropriate cardiopulmonary resuscitation before arrival and prompt transport to a hospital in which specialized treatment is possible are important for initial management rather than in-hospital treatment.

四国医学雑誌 : http://www.med.tokushima-u.ac.jp/article/0012780.html