How acute myocardial infarction should be treated

       The principles are: to protect and maintain cardiac function, to improve myocardial blood supply, to save the dying myocardium, to reduce the extent of myocardial infarction, and to manage complications to prevent sudden death.  I. Monitoring and general treatment: 1. monitoring. 2. rest: bed rest for 2 weeks. 3. oxygenation.  Symptomatic treatment: (a) Pain relief: Pain should be relieved as soon as possible, usually with 50-100mg of inotropes or 5-10mg of morphine, and atropine 0.5mg inotropes to avoid nausea and vomiting.  (B) Shock control: Hemodynamic monitoring should be performed if available, and the cause of shock should be determined according to central venous pressure and pulmonary capillary wedge pressure, and targeted treatment should be given.  (C) Eliminate arrhythmia: arrhythmia is an important cause of exacerbation and death.  (D) treatment of heart failure: strict rest, analgesia or oxygenation, diuretics can be used first, often effective and safe.  Third, save the dying myocardium and reduce the scope of infarction (a) Thrombolytic therapy: apply lysis activator to activate the transformation of fibrinogen into fibrinolytic enzyme in the thrombus and dissolve the thrombus. At present, there are often drugs such as streptokinase and urokinase.  (ii) Anticoagulation therapy: Extensive myocardial infarction or infarction is expanding, application can be considered.  (iii) β-blockers: In the early stage of acute myocardial infarction, the application of insulin or medoxin may reduce the cardiac load and improve the perfusion of myocardial ischemia.  (iv) calcium antagonists: isoptin and nifedipine have a role in preventing or reducing reperfusion arrhythmias to protect the myocardium.  (v) Glucose-insulin-potassium (polarization solution): 1.5g of potassium chloride and 8 units of common insulin are added to 500ml of 10% glucose solution and injected intravenously. Once a day for 7-14 days as a course of treatment, it can promote the lipidation process of free fatty acids and inhibit lipolysis and reduce the concentration of free fatty acids in blood. Glucose and potassium chloride provide energy and restore the polarization state of cardiomyocyte membrane respectively which is beneficial to the survival of cardiomyocytes.  (vi) Intracoronary angioplasty of coronary arteries (PTCA).  (vii) Hormone: early use of hormone in acute myocardial infarction may have a myocardial protective effect.  IV. Treatment during the recovery period Long-term oral aspirin 100mg/day and pansentine 50mg 3 times a day may be given, which have anti-platelet aggregation and prevent reinfarction. The broad-spectrum platelet aggregation inhibitor, Lycopodium, has the effect of reducing platelet adhesion, inhibiting platelet aggregation and releasing clotting factors, etc. It can prevent recurrence after myocardial infarction, dose: 250mg, 1-2 times a day, orally. Stable and asymptomatic disease, 3-4 months later, physical strength recovery, can resume part of the light work as appropriate, should avoid excessive physical work or emotional stress.