The Diagnosis and Treatment of Cardiac Emergencies

Abstract

Situations in which the prompt institution of proper treatment may be directly responsible for the saving of life probably are encountered more frequently in patients who have organic heart disease than in any other group of individuals presenting medical problems. A thorough understanding of the therapeutic measures available for use in cardiac emergencies, therefore, is of considerable importance. Fortunately, practically all of the measures of established value are of such a nature that one can be prepared at all times to use them.

ACUTE MYOCARDIAL INFARCTION

The most common cardiac emergency is acute coronary artery occlusion with infarction of the myocardium. The clinical picture of this condition is too well known to warrant detailed description. The pain is similar to that of angina pectoris, but is more severe and of longer duration. Symptoms of shock of mild to severe degree usually appear soon after the onset, and fever and leukocytosis generally develop within the first 24 hours. A pericardial friction rub may appear at any time during the first few days after the attack and may last for only a few hours or for several days. The electrocardiogram shows characteristic changes in practically every case if records are made at daily intervals and if both standard and precordial leads are used.

The first aim in the treatment of acute myocardial infarction is to relieve the pain. For this purpose aminophyllin is administered by intravenous injection, usually in a dose of 0.48 gm. in 20 cc. of solution. In certain patients. . .