[The importance of an early stress test in patients with myocardial infarct and heart failure in the acute period of the disease].

The mechanisms of acute myocardial infarction depend on the site of myocardial infarction (MI). In anterior MI, the main factor is a large area of injury; in inferior MI, of importance is dysfunction of the papillary muscles and multiple lesions of the coronary artery in addition to the above factor. The site, the area of injury and the status of the coronary bed influence the rate, character and prognostic value of early load test criteria and contractile function of the left ventricle. In anterior MI, elevation of the ST segment is the most frequent criterion; in inferior MI, its depression. Their combination with other criteria for test discontinuation point to multiple lesions of the coronary artery. In patients with anterior MI, the ejection fraction of the left ventricle amounting to 40%, inadequate growth of AP, anginous pain and the T dominant elevation of the ST segment are unfavourable predictors, allowing the patients to be differentiated in accordance with the risk of postinfarction complications.