Emergency department management of acute myocardial infarction

Myocardial infarction remains one of the leading causes of death among adults in the United States despite the significant advances in therapy made during the past three decades. However, a significant reduction in mortality following acute myocardial infarction has been accomplished through an aggressive strategy directed toward early recognition and intervention. This approach requires that the emergency physician act promptly and choose appropriately from the ever-expanding therapeutic options. This paper summarizes the recent progress and treatment options in the management of acute myocardial infarction with regard to prehospital care, diagnostic challenges in the emergency department, conventional therapy and pharmacologic advances, newer interventional measures, and future trends.