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Facts and Hopes in Thrombolysis in Acute Myocardial Infarction
It was a great pleasure for us to welcome so many experts from all over the world to our symposium in Aachen. We are also pleased - and you can attribute this to my own vanity - with the success and acceptance of the concept of myocardial reperfusion and revascularization - specifically selective intracoronary lysis followed either by PTCA or bypass surgery - which we have been pursuing since 1979. But after the dramatic immediate effects of the first attempts, which you have to experience yourself, we did not expect it to be any different. We decided against performing a randomized study in which every patient is catheterized, and thrombolytic therapy only given to some of the patients, for...
Coronary Bypass Surgery in the Elderly
Coronary artery bypass surgery in the elderly: Too often or too seldom? It is a testimony to scientific advances that raising a simple inquiry today, such as whether coronary artery bypass surgery is done too often or too seldom in elderlypatients, requiresanexplorationofwhatviewsonemightholdonseveral medical as well as non-medical issues. Unlike earlier years when doctors were clinically free to decide what should be done with a patient, health has become an expensive human right, decisions about which also involve the patient, the epidemiologist, the health policy administrator, politicians, the exchequer, and the philosopher. In its broadest definition health has come to mean the core of ...
The Modern Era of Coronary Thrombolysis
Coronary heart disease remains the leading cause of death for men and women in the United States and other industrialized nations. Acute myocardial infarction accounts for a majority of these deaths, approaching 750,000 yearly. Thrombolytic therapy has revolutionized the treatment of myocardial infarction, saving lives to a greater extent than any treatment developed to date. The identification of patients best suited for thrombolytic therapy has been a challenging task, as has the ideal adjuvant strategy. Further, the noninvasic diagnosis of treatment successes and failures, as well as the expeditious triaging of patients requiring mechanical/surgical revascularization have been difficult t...
Electrocardiography and Cardiac Drug Therapy
This book is a comprehensive overview of electrocardiography and the major effects of current cardiac pharmacological therapy on electrocardiography. The text is based on work presented at the International Symposium on Non-invasive Cardiovascular Diagnosis and Therapy, held in May, 1987 at the University of Cologne. The theme of the book is to review, in broad clinical perspective the current state-of-the-art of electrocardiography as it pertains to standard electrocar diograms, exercise testing, ambulatory electrocardiography, electrocardiographic telemetry, and high resolution electrocardiography. Furthermore, advance!, in cardiac drug therapy in relation to diuretics, beta blocking drugs...
Silent Ischemia
"Silent Ischemia, Current Concepts and Management" contains the proceedings of a conference held in Rottach-Egern, West Germany, March 5 to 7, 1987. We are most grateful to the authors for the effort to provide manuscripts before the meeting, to the sponsor, Bayer AG, for their generous support and to the publishers for their efficient collaboration, all of which have made the appearance of this book possible. When discussing silent myocardial ischemia, the first question is: "why is it silent?". To approach this question, a deeper look has to be taken into the pathophysiology of cardiac pain and the excitatory and inhibitory mechanisms involved. It has to be borne in mind that - in contradiction to what the poets have told us so beautifully for many centuries - the heart is a visceral and not a sensitive organ. If asymptomatic ischemia did not carry prognostic significance comparable to the symp tomatic manifestations of ischemia, then the problem of silent ischemia would be very academic and without consequences for treatment. Therefore studies on prognosis of silent ischemia are of great importance, as their results should indicate how aggressively patients are to be managed.
Emergency Echocardiography
This reference consists of state-of-the-art, authoritative chapters by international experts on the role of cardiac ultrasound in emergency clinical settings. Chapters include echocardiography in acute coronary syndromes, acute native and prosthetic valve disease, cardiac tamponade, acute diseases of the great vessels, cardiac-related embolism, car
Invasive Cardiovascular Therapy
In recent years considerable progress and new developments in diagnostic and interventional cardiology have been observed, such as balloon angioplasty of coronary artery stenoses, reperfusion techniques in acute myocardial infarction, new pacing, and cardioversion-defibrillation techniques in ventricular tachyar rhythmias. On 5-8 May, 1985, an international symposium on 'Invasive Cardio vascular Therapy' was held in Cologne, which provided a survey on the experi ment~l and routine therapeutic measures presently available and practiced in cardiovascular medicine. This volume is based on the oral presentations given during the symposium. In five chapters the most important traditional and new ...
Reperfusion and Revascularization in Acute Myocardial Infarction
Numerous new and important findings relating to the reconstruction of disturbed circulatory conditions in the coronary area are reported in this book. Fundamental aspects of therapeutic and prophylactic possibilities are covered in detail. Recommendations are then made to practitioners and clinicians for their everyday work. Critical standards for the indications and risks of the recommended procedures are given. Particular emphasis is laid on the possibilities for revascularization by means of dissolution of blood thrombi. The book aims to present top-level guidance to the pros and cons of reconstructive measures in coronary disorders.
