The Early Management of Myocardial Infarction

• The patient in the acute stage of myocardial infarction generally needs rest, reassurance, and relief from pain. Morphine is the preferred agent; it may be given by various routes and in doses of from 15 to 30 mg. Depending on conditions, the patient may also need hospitalization, oxygen therapy (ordinarily in an oxygen tent with a flow of 9 to 10 liters per minute), anticoagulant therapy (e. g., with warfarin sodium), coronary vasodilators such as papaverine, special nursing care, and particular attention to diet and elimination. After the acute stage, it may be necessary to treat complications such as shock, congestive heart failure, acute failure of the left side of the heart, pericarditis, and certain arrhythmias. Pressor drugs like mephentermine and levarterenol have improved the outlook of the patient in shock. Inflation and deflation of four sphygmomanometer cuffs may be carried out in clockwise order on the four extremities to relieve pulmonary edema. During the recovery period, attention must be given to the gradual discontinuance of medication, the establishment of favorable personal and environmental attitudes, and the gradual resumption of physical activity.