The Biology of Myocardial Infarction

Myocardial infarction is a dreaded companion of the civilization of our time. The "heart attack," the coronary thrombosis, the myocardial infarction lurk behind the corner, striking strangers, patients, friends, and ourselves. The toll taken by this single "disease" in many hospitals equals or even exceeds that from almost all other diseases together. Must it be so? This is the question many physicians, and the lay public, are asking themselves today. Identification of some areas where our knowledge is particularly deficient is stressed. We must concentrate our efforts on reevaluating practices and procedures that have brought both the greatest success and the worst failures, at the same time that we ask ourselves what goals could be considered realistic. If myocardial infarction is the evil of our time, what does this mean in a greater biological context-in the evolution of human life and endeavor as viewed in perspective? Are we dealing with a "disease" in the restricted sense of the word, or are we dealing with a way of life and a consequent mode of death? If so, what can be done to achieve the goals of health as defined by the World Health Organization? In what terrain are the forces to be assembled and the battle to be fought-and by whom.