Cad / MI Flashcards
Definition MI
Acute myocardial ischemia with evidence of cardiomyocyte death
Modifiable risk factors
Physical inactivity
Poor diet habit
Cigarette
Alcohol
Hypertension
DM
Dyslipidemias
Obesity
Non modifiable risk factors
Age more 45 years old for men
More than 55 yo for women
Race
Male
Family history
2 types of MI
STEMI
NSTEMI
Pathophysiology
Obstruction or narrowing of lumen of vessels ( atherosclerosis mostly ) leading to decreased perfusion to the heart.
Difference between STEMI and NSTEMI
STEMI has a rupture in the epithelium of atherosclerosis plaque leading to thrombus formation leading to near total occlusion
NSTEMI , occlusion is not near total. More blood flow
Typical symptoms of mi
Chest pain retrosternal , sudden onset , radiation to left shoulder
Nausea
Diaphoresis
Atypical symptoms of mi
Epigastric pain
Dyspnea
Orthopnea
No pain
Investigations
ECG
ECHOCARDIOGRAM
CADDIAC ENZYME TROPONIN
FBC
LIPID PROFILE
FBS
ECG findings in MI
ST elevation
T wave inversion in contiguous lead
Pathological Q waves
New onset left bundle block
Types of cardiac enzymes
Troponin
CK MB
LDH
AST
Most reliable enzyme for MI and why
Troponin because elevated throughout the days
Treatment of MI NSTEMI
O2 therapy with caution
Dual antiplatelet therapy - aspirin 300mg and clopidogrel 600mg
Anticoagulant- enoxaparin
Nitrates for symptoms relief
Bblockers
Statins- artovastatin, rosuvastin
Analgesia with morphine
Risk factor management
Monitoring and discharge
Treatment of STEMI
Angiography with per cutaneous coronary intervention for reperfusion
Fibrinolysis with fibrinolytic agents - streptokinase, alteplase, tenecteplase
Complications of MI
Heart failure
Atrial fibrillation
Ventricular fibrillation
Ventricular septal defect
