[Preinfarct and prehospital care of myocardial infarction].
In intensive therapy units, especially in guarded wards for coronary diseases, the lethality in acute myocardial infarction could be reduced by ca. 50%. However, these favourable results are nowadays of importance for the patients concerned only then, when the diagnosis myocardial infarction or the tentative diagnosis infarction are made in a short period and already prehospitally adequate measures are begun. The following measures are in the centre of prehospital care: Immediate home visit when a suspicion of infarction is present, immediate hospitalisation into an in-patient facility, alleviation of pain, immediate treatment of complications (disturbances of cardiac rhythm, shock, pulmonary oedema, cardiac arrest), prevention of disturbances of the cardiac rhythm. According to the modern knowledge is to be assumed that about 50% of the patients with infarction undergo a premonitory stage which lasts for hours, days or weeks. It is possible that here develop concrete approaches to an infarction prophylaxis. In the first place there are an increase of frequency, intensity and duration of the attacks of angina pectoris, insufficient responsiveness to nitrangin, provocation of the attacks by slight causes and changes of the ECG as they are typical for the inner layer and outer layer ischaemia and the so-called rudimentary infarction. The treatment of the preinfarction process should immediately be begun, at best under clinical conditions.