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Page 13
allied
academies
March 04-05, 2019 | London, UK
European Nursing Congress
Journal of Intensive and Critical Care Nursing | Volume 2
Acute myocardial infarction (AMI) is known to physicians for
just a little more than hundred years. While it was obvious
that people die suddenly, it remained unclear what the cause
might be. At the beginning of the last century Russian scientists
described the clinical entity of AMI, but for decades no effective
treatment was available. In 1955 when Pre-sident Eisenhower
had his heart attack not much was at hand to treat this patient.
In 1956, Paul Zoll developed the external defibrillator which
for allowed to effectively treat ven-tricular fibrillation, a major
cause of death in AMI. Later, betablockers, aspirin and throm-
bolysis allowed for a more effective management. In 1977,
Andreas Grüntzig developed coronary angioplasty which
eventually allowed to reopen occluded coronary arteries, the
underlying cause of AMI, using urgent cardiac catheterization.
Thanks to the availability of platelet inhibitors and later stents,
in-hospital mortality of acutemyocardial infarction has dropped
from over 50% to 7-10% currently. However, cardiogenic shock
remains a major challenge with in-hospital mortality rates
of around 40% in spite of acute cardiac care and ventricular
assist devices. Modern acute management of AMI requires
an effective coordination and teamwork of highly trained
paramedics, nurses andemergency physicians and cardiologists.
After an AMI, the event rate remains around 15% in the
first year requiring effective secondary prevention involving
statins and Niemann-Pick-transporter inhibitors to lower LDL-
cholesterol, antihypertensives, modern antidiabetics and
platelet inhibitors to lower cardiovascular events. Furthermore,
ACE-inhibitors must be considered to prevent left ventricular
remodeling and heart failure. Thus, AMI patients must remain
in close supervision of competent nurses and physicians
even after the event to reduce the ongoing risk of another
myocardial infarction, heart failure and death. New lipid-
lowering and anti-inflammatory drugs among others are at
the horizon to further improve prognosis of these patients.
Speaker Biography
Thomas F Lüscher studied at the University of Zurich, trained in cardiology at the Mayo
Clinic in the USA and was Professor of Pharmacotherapy at the University of Basel,
Professor of Cardiology at the University of Berne and Professor and Chairman of
Cardiology at the University Hospital Zurich He is now Director of Research, Education
& Development at the Royal Brompton & Harefield Hospitals and Professor at Imperial
College in London. He is a general and interventional cardiologist with a broad clinical
scope and large experience. His research focuses on coronary artery disease and acute
coronary syndromes. He has published extensively research articles and reviews and
the ESC Textbook of Cardiovascular Medicine. By the Institute for Scientific Information
he has been rated as one of the 0.5% most cited scientists worldwide. He has obtained
numerous awards and is editor-in-chief of the European Heart Journal, currently Nr. 1
worldwide in cardiology.
e:
Thomas F Lüscher
Imperial College and Royal Brompton & Harefield Hospitals, UK
Acute Coronary Syndromes – From Eisenhowers Heart Attack to the Future of Cardiology