Coronary Heart Disease and Risk Factors [antikvár]

Introduction The rate at which knowledge in cardiology and medicine in general !j continues to increase reflects, in part, the tremendous improvements !i being made in the diagnosis and treatment of disease. Progress often signifies new technologies and/or new therapies based on new insights into the pathogenesis of the disease. Thrombolysis and its adjunctive '' therapy stems from newer insights into thrombosis and coronary reoc- | elusion. In an attempt to keep pace with this expanding pool of information, we are often forced to spend a greater proportion of our time reading journals rather than comprehensive reviews or textbooks. This approach is necessary and laudable, however, this may have some significant limitations. One may not keep pace with the knowledge fundamental to ones understanding of the reasons that dictate the trends. A full knowledge of the principles fundamental to the change is often necessary to fully appreciate its impact, its limitations, as well as the j ability to anticipate and prepare for the next progressive trend. Thus, we have attempted to review the field emphasizing the basics and pro- ! viding an overview of current techniques and therapy in the treatment ' of ischemic heart disease. Thrombolytic therapy, the role of angioplasty, as well as when to perform cardiac catheterization post-thrombolysis has been established ; and routine cardiac catheterization is no longer necessary. The non-Q-wave infarction, which now accounts for nearly one half of patients with infarction, appears not to benefit from thrombolytic therapy but exhibits i significant benefit when treated with diltiazem and aspirin. The role of I angioplasty in ischemic heast disease following thrombolytic therapy, [ acute infarction, and chronic ischemia has been better defined as have the appropriate adjunctive medical therapies. Similarly, medical therapy in the patient following Q-wave infarction, whether they have received thrombolytic therapy or angioplasty, has been established. The therapy of unstable angina has been revolutionized with the use of heparin and/ ix