MI

Question 1

Structural abnormalities

Answer 1

narrowing of arteries as a result of coronary atheroma

Blockage of artery due to blood clot

Question 2

Physiological abnormalities

Answer 2

Ischaemia –> necrosis of heart muscle
Impaired contraction of myocardium
abnormal electrical activity of heart cells

Question 3

Prior events

Answer 3

More common in men
family history
Risk factors

Question 4

Symptoms

Answer 4

severe crushing central/generalised chest pain- sudden onset
Pain radiates to arm/neck
associated- nausea, vomiting, sweatiness, breathlessness

Question 5

Signs

Answer 5

Distressed due to pain
Low BP and fast heart rate
Breathlessness
Maybe fluid heard on lungs during inspiration due to pulmonary oedema

Question 6

Abnormal test results

Answer 6

ECG: ST segment elevation if coronary artery completely blocked
Blood test: raised heart protein troponin
Echocardiogram shows reduced contraction of area affected
Coronary angiogram- shows blocked artery

Question 7

Medical/surgical intervention

Answer 7

Immediate; pain relief- morphine, High flow O2, oral aspirin treatment
Primary percutaneous intervention (clot removed, small balloon opens narrow artery, stent placed in artery to hold it open)

Question 8

Primary and Secondary prevention

Answer 8

Drugs:
Aspirin- anti-platelet
Clopidogrel- anti-platelet
Beta blockers- lower heart rate and BP (block affects of NA and adrenaline)
Statins- HMG-CoA reductase inhibitors- lower cholesterol
Ace inhibitors- prevent production angiotensin II