Acute MI

Question 1

what is it

Answer 1

ischaemic necrosis of a tissue of myocardium secondary to occlusion/reduction of the coronary blood supply

Question 2

what are symptoms

Answer 2

severe crushing, heavy central chest pain
radiates to jaw and arms 
not relieved by STN
sweating, nausea and vomiting
>20 mins duration 
thready pulse

Question 3

what is cause

Answer 3

atherosclerosis of coronary arteries

Question 4

how is it diagnosed

Answer 4

symptoms
ECG
raised cardiac enzymes in blood (troponin I, T or CK)
transthoracic echo may be helpful

Question 5

what is ECG findings

Answer 5

ST elevation, T wave inversion, Q waves

Question 6

how is it treated

Answer 6

Morphine + anti emetic
Oxygen
Nitrates
Aspirin and Clopidogrel

Question 7

what drugs are given post MI

Answer 7

dual anti platelet therapy (aspirin and clopidorel), B blocker, ACEI and statins

Question 8

what reperfusion therapy used

Answer 8

thrombolysis (if PCI not available in time)
PCI (within 90 mins - 120 max)
CABG (reserved for complications of MI)

Question 9

what is thrombolysis

Answer 9

uses streptokinase (or alteplase) to cause thrombolysis by activating plasminogen to plasmin and dissolving thrombi

Question 10

when is thrombolysis contradicted

Answer 10

trauma
haemorrhage 
stroke 
recent surgery 
severe HT
ulcers

Question 11

what is complications

Answer 11

death, arrhythmia (esp ventricular tachycardia), cardiac rupture, aneurysm, inflammation, septal defect, mitral regurgitation, dresslers, ventricular dysfuncition, HF, cardiogenic shock

Question 12

what is dresslers syndrome

Answer 12

pericarditis many weeks post MI, damages heart muscle