Left ventricular failure complicating acute myocardial infarction--problems and potential of nonthrombolytic therapy.

Despite recent advances, problems in the treatment of acute myocardial infarction still remain. In the earliest stages of the syndrome thrombolysis holds substantial if not absolute promise but many patients present too late for it to be effective. In these latter individuals and those in whom thrombolysis was not successful, the major mortality risk is concentrated in those with left ventricular failure. Many drugs, including diuretics, vasodilators, ACE inhibitors and positive inotropes, singly or in combination, may be used to manipulate the circulation and correct partially or completely the abnormal circulatory profile. Despite such haemodynamic efficacy the impact of drug therapy on the high morbidity and mortality risk of patients with acute myocardial infarction complicated by left ventricular failure is still unknown.