Use of Drugs in Shock Accompanying Myocardial Infarction

Shock is one of the most dreaded sequels of acute myocardial infarction. Its mortality rate, estimated at about 80%, is approximately three to four times higher than the over-all mortality of acute myocardial infarction, as based on unselected series, and more than 20 times higher than some "good-risk" series. With arrhythmias and thromboembolic phenomena, it constitutes a triad of complications of myocardial infarction, the elimination of which would tremendously improve the prognosis of a single attack. Within the past decade the therapeutic approach to shock accompanying myocardial infarction has changed from passive and symptomatic treatment to an active and vigorous use of drugs including blood volume expanders. The evaluation of such therapy and the establishment of a clear-cut policy are difficult for two reasons. In the first place, the causes and mechanism of this form of shock are not well understood. Secondly, the extreme seriousness of this condition precludes all