General support measures
1) Pain control - Control of pain will reduce myocardial
oxygen consumption and levels of serum catecholamines.
Pain control should be achieved as early as possible to
prevent myocardial damage. Morphine sulfate and/or
meperidine is used intravenously, and special attention
should be paid to blood pressure levels because this medication
may cause severe hypotension with further impairment
of coronary perfusion.
2) Mechanical oxygenation and/or ventilation – Oxygen
administration by nasal catheter with 2 to 3l/min provides a
greater oxygen supply to the tissues. Control of the blood gases
must be made for therapeutic optimization. If required,
mechanical ventilation should be installed, providing a
reduction in oxygen consumption by thoracic muscles.
3) Sedation – Many times, in addition to analgesia,
sedation with intravenous alprazolam or diazepam is
necessary, at a dose of 5mg or greater, as required.
4) Treatment of arrhythmias, metabolic acidosis and/
or hypovolemia – These conditions may contribute to shock and, when corrected in time, the patient’s hemodynamic
state can be reversed, influencing the prognosis