علائم انفارکتوس حاد
علائم درد قفسه سينه شبيه به آنژين است ولى شديدتر و پايدارتر (بيش از 30min) مىباشد و استراحت يا نيتروگليسيرين بهبود کامل نمىيابد و اغلب با تهوع، عرقريزش و احساس ترس (Apprehension) همراه است. با اين حال ۲۵% از موارد MI از نظر بالينى خاموش مىباشد.
معاينهٔ بالينى انفارکتوس حاد
معاينه بالينى ممکن است رنگپريدگي، عرقريزش (Diaphoresis)، تاکىکاردي، S4 و ايمپالس قلبى ديسکينتيک (Dyskinetic) وجود داشته باشد. در صورت وجود CHF: رال، S3، اتساع وريدهاى ژوگولار در انفارکتوس بطن راست شايع است.
درمان انفارکتوس حاد
هدف، تخفيف درد، به حداقل رساندن وسعت بافت انفارکته و پيشگيرى ودرمان آريتمىها و عوارض مکانيکى است. آسپيرين بايستى فوراً تجويز گردد (۳۲۵-۱۶۰ mg را در زمان مراجعه بجود و سپس ۳۲۵-۱۶۰ mg در روز بهصورت خوراکى داده شود) براى MI داراى موج همراه با بالا رفتن قطعى درمان ترومبوليتيک زودهنگام با استرپتوکيناز، رتپلاز، يا فعالکنندۀ پلاسمينوژن بافتى (tPA) مىتواند اندازهٔ انفارکوس و مرگ و مير را کاهش دهد و اختلال عملکرد بطن چپ را محدود کند. در کانديدهاى مناسب (اشکال – رويکرد به درمان ترومبوليتيک در بيماران مبتلا به MI حاد – و – تدابير درمانى در بيماران مشکوک به بالا رفتن قطعهٔ ST.) بايستى ترومبوليز را در سريعترين زمان ممکن (بهطور مطلوب در 30min) در اتاق اورژانس يا واحد مراقبت کرونر (CCU) آغاز نمود.
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