[ST elevation in the initial phase of myocardial infarct--a sequela of acute coronary occlusion of an expression of neurohumorally-induced metabolic processes?].

The artificial coronary artery occlusion results immediately in ST-segment elevation (ST-E), therefore the ST-E in acute myocardial infarction is considered to be the result of acute coronary occlusion. But in the early phase of myocardial infarction a significant correlation between ST-E and occlusion of the coronary artery does not exist. The early ST-E seems to be predominantly the consequence of sympathico-adrenergic induced metabolic processes in the ischemic myocardium. The beta receptor blockade during the first 90 minutes after the onset of infarction decreased the ST-E by 73 +/- 6% within one hour. Treatment with beta receptor blockers in the acute phase in all patients with first anterior wall infarcts accompanied with ST-E leads to a favorable prognosis. Early ST-E can therefore be considered as a sign of sympathico-adrenergic induced changes in myocardial metabolism. Thus the beta receptor blockade in the acute phase (of anterior wall infarctions) seems to be therapeutically indicated.