B4-074 Myocardial Infarction Flashcards
modifiable risk factors for CAD and MI
- hypertension
- dyslipidemia
- diabetes
- smoking
- tobacco
- obesity
- sedentary lifestyle
nonmodifiable risk factor, but very important for CAD and MI
family hx
cell death results in damaged or destroyed heart tissue
myocardial infarction
- causes severe chest pain or discomfort
- medical emergency that requires prompt dx
acute coronary syndrome
goals of treatment for acute coronary syndrome
- improving blood flow
- treating complications
- preventing
“typical” chest pain
- substernal
- provoked by excertion/stress
- relieved by rest or nitroglycerin
“atypical” chest pain
2 of the typical characteristics
“noncardiac” chest pain
meets 1 or none of the typical characteristics
common symptoms of acute coronary syndrome
- chest pain
- SOB
- abdominal pain
- back pain
- dizziness
- nausea
- sweating
most important initial clinical test for diagnosis of MI
12 lead ECG
serial ECGs can be beneficial as well
ST depression
NSTEMI
T inversion
NSTEMI
ST elevation
STEMI
proteins found in skeletal and cardiac muscle fibers that regulate muscular contraction
troponin
a troponin test measures
troponin I or T
released when the heart muscle has been damaged
troponin
preferred biomarker for myocardial injury
troponin
caused by sudden complete blockage of coronary artery
STEMI
caused by severly narrowed artery, which is not usually occluded
NSTEMI
both STEMI and NSTEMI demonstrate elevated
biomarkers
intial therapy for acute myocardial infarction is directed toward
restoration of perfusion
medical management of reperfusion
- aspirin, heparin
- thrombolytics
mechanical management of reperfusion
- percutaneous coronary intervention
- CABG
early interventions and supportive measures
- morphine/pain control
- Oxygen >94%
- Nitrate
- Anti-platelet: Aspirin
- Beta blockers
- Ace inhibitor
- Statin
- Heparin
MONABASH
used to lyse blood clots by activating plasminogen
fibrinolysis
fibrinolysis is only used in
STEMI
only used when primary PCI not available with 90 minutes
fibrinolysis
if used, should be administered within 30 minutes of patient presentation
fibrinolysis
PCI: catheter thread though femoral or radial artery to the
aortic root
PCI: guide wire is inserted and advanced
past stenosis
metal mesh
percutaneous coronary artery stent
major surgical procedure requiring sternal incision and cardiopulmonary bypass
CABG
reserved for patient with multiple arterial stenoses
CABG
post MI complications: 1-3 days
- ventricular arrhythmias
- bradyarrhythmias
- cardiogenic shock
- stroke
post MI complications: 3 days - 2 weeks
- ischemic MR/papillary rupture
- ventricular septal rupture
- LV free wall rupture
post MI complications: > 2 weeks
pericarditis
