Circulation in Acute Myocardial Infarction

Myocardial infarction as a clinical entity differs in many respects from other forms of heart disease. In most other conditions leading to cardiac strain and insufficiency the abnormal process affects the heart slowly and gradually, allowing some time for adjustment and adaptation. In infarction the lesion in the myocardium develops suddenly, resulting in partial necrosis of it, and in surviving patients the remaining healthy muscle takes over the function of the whole unit instantaneously. The derangement of the circulation resulting from this sudden insult to the heart is well suited for clinical study, because the exact time of its onset is usually clinically evident. The clinical picture of myocardial infarction is well known. A great deal of work has been done on the clinical aspects, laboratory findings, course and prognosis of acute infarction, but only a few papers have dealt with the mechanism of circulatory adjustment following the attack. Experimental