Use of hemodynamic measurements for management of acute myocardial infarction.

The modern coronary care unit now can provide hemodynamic measurements that characterize the determinants of myocardial oxygen consumption and mechanical performance. These determinants of preload, afterload, contractile state, and heart rate can be obtained from measurements with the Swan-Ganz catheter, systemic blood pressure, assessment of ventricular function, and heart rate. With the hemodynamic characterization of the determinants of left ventricular function, drugs can be selected that either decrease or increase the specific determinants in order to optimize left ventricular performance. Thus, a physiologic approach can be taken to the pharmacologic management of patients with acute myocardial infarction based on hemodynamic measurements and appropriate therapeutic strategies.