acute MI Flashcards
normal ecg regions?
what is st eelevation>
above 1mm above baseline,(limb) 2mm chest
0.08 sec to right o J point
look for in two or more leads facing same area
classical clinical symptoms?
when to ecg?
drugs for antithmbotics?
advantages of thrombolysis?
Effective if given early (within 3-hours of pain)
Saves 30 lives in 1000 patients treated within 6 hours
Saves 20 lives in 1000 patients treated between 6-12 hours
Can be given in any hospital
Can be given in the back of an ambulance
disadvantages of thrombolysis?
30-40% of AMI patients are unsuitable for lysis
Less effective as time goes on
Coronary patency restored in only 35-87%
After lysis
Recurrent ischaemia in 20-30%
Early reinfarction in 3-5%
Major haemorrhage 2-3%
Reperfusion assessed at 90min = resolution of chest pain + reduction of ST elevation by >50%
angiolasty in stemi?
European society of cardiology guidelines?
complicaions of stemi?
Pump failure: shock, pulmonary odema, pre-renal failure
Mechanical: mitral valve damage, VSD, rupture
Electrical: VF, VT, AF
Embolic
Psychological
pharmacological interventions?
non pharm interventions
Risk factor management
Regular exercise/rehab programme
Restriction of salt intake
Avoidance of smoking
Weight reduction in obese individuals
Diet
summary?
First assessment of patient with chest pain is ECG
Then assess history and examination
Not all STEMI typical pain
First treatment is O2, analgesia, nitrates
Primary PCI should be the treatment of choice in patients presenting with STEMI in a hospital with PCI facilities
Otherwise administer thrombolysis
(consider transfer for primary PCI if delay in presentation)
Rescue PCI recommended if thrombolysis fails within 90min
Keep a close eye out for post-STEMI complications
Get the patient on all right secondary medicines
Don’t forget the non-pharmacological interventions
