[Variants of hemodynamic changes in acute period of myocardial infarct and the importance of their detection for treatment]

Abstract

Sixty-three patients suffering from acute myocardial infarction were examined within the first 24 hours of the disease (27 within the first 6 hours) by means of catheterization of the right parts of the heart with a Swan-Ganz balloon catheter and thermodilution. Comparison between the cardiac output and the pressure of left ventricular filling allowed the following hemodynamic variants of myocardial infarction to be distinguished: normo-, hypokinetic, with increased pressure of left ventricular filling and normal cardiac output, hypovolemic, and hyperdynamic. The results of the tests with acute rheopolyglucin load (9 patients) showed that some of the patients with normal values of hemodynamics had latent cardiac insufficiency. Hemodynamic study and recognition of the variant of hemodynamic changes in the acute period of myocardial infarction made it possible to determine properly the indications for the use of vasodilators, active inotropic agents, and infusion therapy.