11 - MI Flashcards
1
Q
classic presentation of MI
A
crushing retrosternal chest pain with pain shooting down L arm and jaw and diaphoresis
2
Q
what is more common in elderly Sx
A
- no pain or diaphoresis
- syncope, stroke, acute confusion
3
Q
parts of Phx for MI
A
- appearance
- vitals
- JVP
- auscultation
- cardiac exam
- peripheral pulses
4
Q
3 early and subtle ECG changes in actue MI
A
- increase in R wave voltage in precordials
- hyperacute T wases in precordials
- symmetric and prominents - ST elevation
5
Q
what is worse prognosis on ECG
A
higher ST elevation and more leads involved
6
Q
investigations
A
- CXR only a priority for ruling out dissection
- trops, but don’t rise for 2-6 hours
- serial trops
7
Q
6 complications of acute MI
A
- arrhythmias
- conduction disturbances
- LV pump failure
- mech. defects
- thromboembolism
- pericarditis
8
Q
**4 Tx priorities in STEMIs
A
- ASA
- thrombolysis or PCI
- LMWH
- clopidagrel
9
Q
steps to mgmt of MI
A
- stabilize
- O2 - pharma
- ASA
- nitro, except in inferior MI - reperfusion therapy - thrombolysis or PCI
- heparin
- BB
- clopidogreal
10
Q
contraindications to TPA
A
- recent major surgery or active bleed
- Hx of hem. strokes
- severe uncontrolled HTN
- intracranial neoplams
- suspect aortic dissection
11
Q
preferred thrombolytic therapy
A
PCI
12
Q
2 recommendations for PCI
A
- should get in 90minutes
2. if can’t get within 90 minutes then give fibrinolytic therapy
13
Q
4 adv. of LMWH over heparin
A
- more predictable anti-coag
- no need to monitor PTT
- lower rates of thrombocytopenia
- better bioavailablilty
