ABSTRACT

INTRODUCTION Despite an excellent angiographic result after percutaneous intervention (PCI) or thrombolysis for acute myocardial infarction (MI), there is often a dissociation between the angiographic result and clinical outcome [1]. With the introduction of sophisticated imaging and diagnostic modalities within the last two decades, it has become apparent that embolization and microcirculatory dysfunction (MCD) occur considerably more often than expected [2]. In this chapter, we will review the enhanced imaging and diagnostic assessment of MCD as well as set the foundation for improved pharmacological and mechanical approaches to protect the integrity of the microcirculation in acute MI.