MI Flashcards
What are the classical signs & symptoms of MI?
Central chest pain - "crushing", "tight band" Radiation to left arm, jaw, back Grey colour Clammy Sweaty Breathless
What is a gastrointestinal differential diagnosis of MI?
Acid reflux
How many times should angina spray be taken before phoning ambulance?
Twice - still chest pain, call ambulance
Chest pain >30 minutes
What are some of the predisposing factors to MI?
Angina Hypertension High cholesterol Peripheral arterial disease Obesity Family history
What is the pathogenesis of an MI?
Atherosclerotic disease - plaque rupture (could be due to insertion of stent)
Aggressive clotting response causing thromboemboli
Coronary artery lumen occluded
Oxygen not able to perfuse myocardium
What are some of the complications that can occur following MI?
Cardiac failure Dressler's syndrome Arrhythmias Sudden death Angina Mitral incompetence Pericarditis Cardiac rupture Ventricular aneurysm
What ECG changes might be seen in an acute MI?
ST elevation in STEMI
ST depression - could be NSTEMI
Long term - pathological Q waves
Which ECG leads would show ST elevation in inferior MI?
AvF, 2, 3
Which ECG leads would show ST elevation in anterior MI?
Usually, V3 & V4
But, any of V2-V5
Which ECG leads would show ST elevation in anteroseptal MI?
V1-V4
Which ECG leads would show ST elevation in anterolateral MI?
V4-V6, AvL, 1
Which ECG leads would show ST elevation in a lateral MI?
1, 2, AvL
What is the initial treatment for patients presenting with acute MI?
Remember: MONA+C Morphine Oxygen Nitrates Aspirin Clopidogrel
Consider an anti-emetic
Which length of time determines the treatment for the patient?
90 minutes
Which treatments are available (dependant on the time passed from onset of symptoms)?
90 minutes: thrombolysis e.g. with streptokinase
