L16 - Management Of MI Flashcards
What two things are required to diagnose an MI
Sufficiently elevated troponin AND symptoms of ischaemia/ST elevation/pathological Q waves/imaging evidence/thrombus on imaging
What’s the difference between type 1 and type 2 MI’s?
Type 1 is the result of atherosclerotic plaque rupture where as type 2 is a condition other than this rupture resulting in the myocardial oxygen starvation
Complications of MI can define its severity, what are some potential complications as a result of MI
Pulmonary oedema/effect on LV function/has a post MI atrial septal defect occurred? Is there regurgitation due to damaged valves?
Following diagnosis of an MI troponins will be taken, an ECG will identify where the infarction is and then an angiogram of that artery will take place. Which coronary arteries of the heart are affected if an ECG indicates
a) inferior changes
b) anterior changes
C) lateral changes
A) RCA
B) LAD
C) left circumflex/marginal/diagonal
What tests would you run following an MI to look for complications/ to investigate a suspected ACS
coronary angiogram/Chest x-Ray (pulmonary oedema)/ u’s and e’s to look for kidney damage as a result of cardiogenic shock/ECG to look for arrythmias/troponins/echocardiogram to look for septal defects/FBC to look for anaemia or sepsis
Describe where the chest leads 1-6 are placed
C1 - 4th intercostal space, right parasternal
C2 - 4th intercostal space, left parasternal
C3 - midway between c2 and c4
C4 - fifth left interspace, mid clavicular line
C5 - fifth left interspace, anterior axillary line
C6 - fifth left interspace, mid axillary line
What are the following ECG territories
A) v1-v4
B) 1, aVL, V5 and V6
C) II, III AND aVF
A) anteroseptal (LAD)
B) lateral (marginal/circumflex)
C) inferior (RCA)
What bloods would you ask for post MI
FBC
U AND E
Lipids
Troponins
Which troponin is most commonly tested for?
Troponin I
