MI Flashcards
Treatment of MI
diMorphine + anti-emetic Oxygen - high flow Nitroglycerin (GTN) Aspirin - 300mg Clopidogrel - 300mg
when should patients be treated with PCI
within 90 mins
what should happen is PCI can’t be done within 90 mins
fibrinolytic therapy within 30 min
what are contraindications of thromboylsis
recent surgery/trauma/head injury
peptic ulcer
recent stroke
examples of anti-emetics
metoclopramide
cyclizine
what are complications of MI
Arrhythmias Ventricular Septal Perforation Ventricular Free Wall Rupture Systemic Embolism Ventricular Aneurysm Pericarditis Cardiogenic Shock
if a patient was hypotensive what drug would you not give
nitrates
what should patients be offered after an MI (drugs)
ACEi Aspirin Beta blocker Statin Aspirin and Clopidogrel
if a patient has signs of HF what should they be offered
aldosterone antagonists e.g. spironolactone
what is the features of chronic angina
fixed stenosis
demand led ischaemia
predictable
what is the features of acute coronary syndrome
dynamic stenosis
supply led ischaemia
unpredictable
what are the steps of the platelet cascade
1 - initiation 2 - adhesion 3 - activation 4 - release of activators (e.g. ADP, TA2) 5 - activators bind to receptors 6 - amplification of platelet activation 7 - triggers inflammatory cascade 8 - organised thrombus
what is the classic features of an MI
Severe crushing central chest pain
Radiating to jaw and arms, especially the left
Not relieved by GTN
Associated with sweating, nausea, vomiting
what are the signs of STEMI that must be on an ECG
> 1mm ST elevation in 2 adjacent limb leads
OR
2mm ST elevation in at least 2 precordial leads that are next to each other
what are arrhythmic complications of an MI
Ventricular fibrillation
