Managing patients with myocardial infarction after hospital discharge.

Long-term management of patients following myocardial infarction requires assessment of both residual ischemia and left ventricular function, since these are the primary factors in determining the patient's prognosis. Most patients with uncomplicated hospital courses should undergo exercise testing and assessment of the ejection fraction. Aspirin and beta-adrenergic receptor blocking agents should be prescribed to most patients, and angiotensin converting enzyme inhibitors and cholesterol-lowering drugs should be administered when indicated. Psychologic issues unique to myocardial infarction must be addressed, and an appropriate exercise program should be prescribed. The goal is to help patients achieve the functional status they had before the infarction.