PHARMACOLOGICAL MANAGEMENT OF ANGINA AND ACUTE MYOCARDIAL-INFARCTION

A concise overview of the pharmacologic management of chronic stable a ngina, unstable angina, and acute myocardial infarction is presented. Nitrates, beta blockers, and calcium antagonists increase exercise tol erance and decrease symptoms in patients with chronic stable angina, a nd aspirin may prevent myocardial infarction. In unstable angina, aspi rin reduces mortality, heparin may prevent myocardial infarction; and nitrates, beta blockers, calcium antagonists, and heparin may decrease angina. In acute myocardial infarction, thrombolytic therapy, aspirin , blockers, and intravenous nitrates may decrease mortality, whereas c alcium antagonists do not affect mortality. Intravenous magnesium may decrease the incidence of ventricular tachycardia, ventricular fibrill ation, and mortality in patients with acute myocardial infarction. The administration of angiotensin-converting enzyme (ACE) inhibitors afte r the acute phase of myocardial infarction may decrease mortality and prevent reinfarction in patients with left ventricular dysfunction.