MANAGEMENT OF ACUTE MYOCARDIAL INFARCT
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1)Oxygen
2)Nitroglycerin  oral to IV
	except w/inferior wall,Decr. BP,
	or Rt. Ventricular MI & BP<90
3)Morphine for analgesia
4)Countershock for V. Tach.
5)Atropine w/:
	-Sinus Bradycardia w/Hypotension
	-Type I 2nd degree AV block
	-Inferior MI
	-Asystole
	-To counteract Hypotension &
	  Bradycardia after Nitro
6)Monitor w/ EKG
7)Swan-Ganz Catheter w/:
	-CHF, severe & Progressive
	-Cardiogenic Shock
	-Acute MI w/ Papillary Muscle
	 rupture or V. Septal Defect
8)Lidocaine for:
	-Acute MI, ischemia w/ PVC
	-V. Tach or V. Fibrillation
9)Pacemakers w/:
	-Asystole
	-Complete Heart Block 
	-Right Bundle Branch Block
	-Left Bundle Branch Block
	-Type II 2nd Degree AV Block
	-Type I 2nd Degree Block not 
	 responding to Atropine.
	-Bradycardia not responding to 
	 Atropine
10)Investigations:
	-AST, LDH, CK-MB
	-Echocardiography
	-Infarct Scitigraphy 
	 (Technetium 99 Pyrophosphate)
11)Beta Blockers in:
	-Reflex Tachycardia
	-Hypertension without CHF
	-Tachyarrthmias
	-Post Infarction Angina
	-Atrial Fibrillation
	-NOT IF:
		HR <60
		Systolic BP <100
		L. Ventricular Failure
		Peripheral Hypotension
		Type I or II AV Block
		Complete heart block
		COPD
12)Calcium Channel Blockers for:
	-Post infarct Angina
	-Non Q Wave Infarct Angina
	-Post Angioplasty to decr. spasm
13)Thrombolytic Agents :
	(Streptokinase, rTPA,Urokinase)
	-Follow treatment with:
		-IV Heparin for 3-4 days
		-160 mg Aspirin daily
		-IV or Topical Nitro
		  for 24-48 Hours Post.
14)Baloon Angioplasty:
	-if within 6 hours p onset of pain
	-if thrombolytic agents fail.
15) the end.