This experiment was designed to explore the systemic and regional hemodynamic changes in experimental myocardial infarction with and without shock and the effects of catecholamne were also studied in both dogs.

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In C0NTRAST to the big Progress made by coronary care unit in the treatment of electrical failure following myocardial infarction, the treatment of pump fauilure following myocardial infarction has not yet seen much progress. We have studied various hemodynamic parameters in patients with myocardial infarction, in the acute stage following the attack, hoping that these patients with myocardia; infarction, in the acute stage following the attack, hoping that tese observations will contribute to the elucidation of pathological physiology of myocardial infarction and that they give some suggestions as to the proper therapy for myocardial infarction.

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Our discussion on the medical treatment of cardiogenic shock:"Several sympathomimetic amines are preferable provided they are carefully used. Norepinephrine and isoproterenol are apparently beneficial for systemic blood pressure. However, our experimental observations suggest their harmful action on the regional myocardium and dependence of their action up on regional myocardial blood flow on severity of coronary artery constriction. Therefore, we consider that further detailed investigations on their action on myocardial blood flow in individual patient are necessitated.

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CARDI0GENIC shock is a major complication of coronary artery disease. Ten to twenty percent of patients with acute myocardial infarction develop shock and the mortality of shock is still extremely high. Probably the most serious shortcomings to the proper management of cardiogenic shock are the lack of understanding of Pathophysiologic changes which may facilitated eterioration of the myocardial performance in shock. Previous investigations indicate that the degree of cardiac impairment does not necessarily correlate with the extent of initial infarcts; instead, it seems to depend on the function of the remaining viable myocardium. In this connection, a myocardial depressant factor (MDF) has been reported to accumulate tn the plasma of experimental animals and patients with circulatory shock that exerts a marked depressant effect on the heart muscle. The present study was undertaken to clarify the properties and possible significance of this myocardial depressant factor in cardiogenic shock.

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THRE are many reports concerning to the treatment of cardiogenic shock with pharmacological approaches, but stell controversy exists regarding definition, physiological and biochemical alteration of body and the efficacy of pharmacological agents used to treat patients. The purpose of this study was to assess the efficacy of intravenous administration of various drugs in cardiogenic shock dogs. Also the present study was carried out to determine when the surgical support should be necessary for maintaining adequate circulation.

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1.It is quite possible that assisted circulation (e.g.counterpulsation) is one of the most reasonable and promising measure to treat cardiogenic shock secondary to acute myocardial infarction. 2. Circulatory assitance will not revive the tissue damaged irreversibly; there must be sufficient viable myocardium left at the time of circulatory assistance to permit restoration of cardiac function. Therefore, it is strongly suggested that effective results can be obtained only by earlier implementation of this procedure.

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It was initially suggested by Virchow(1856) that the cause of suddend death in acute pulmonary embolism was related to an acute decrease in coronary blood flow. In fact. myocardial ischemic change was frequently observed on electrocardiogram and autopsy after acute pulmonary embolism. For years, it was widely believed that acute pulmonary embolism might acctivate a vagal reflex which result in constriction of the coronary arteries. However. recent observations show that pulmonary embolization causes a coronary dilation or no Change. In order to clarify the effects of acute pulmonary embolism on the coronary circulation, the effects of recurrent miliary embolization with Lycopodium Spores on the right coronary blood flow (RCF) or left circumflex coronary bloodt flow (LCF) were studied in the open-chest anesthetized dogs, with special deference to partial pressure of oxygen in arterial blood (Pa0₂) and coronary sinus blood (PcsO₂). The effects of the partial occlusion of pulmonary trunk or pressure infusion into the separated left lower lobar artery on LCF were also studied.

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